万古霉素治疗老年下呼吸道感染临床观察

Lower Respiratory Tract Infection in Elderly Patients: A Clinical Observation on Vancomycin Treatment

目的 了解万古霉素治疗老年下呼吸道感染的临床有效性和毒副作用的发生情况。方法 调查我院 1997年 5月～ 2 0 0 1年 4月住院的中重度老年下呼吸道感染患者 34例 ,31例应用美国礼来公司生产的万古霉素 ,3例应用国产去甲万古霉素 ,每支剂量均 0 5 g(以万古霉素计 ) ,用法 :0 5g加 5 %葡萄糖液或生理盐水 10 0ml静脉滴注 ,每日 2～ 3次 ,疗程 4～ 6 2d。结果 2 2例痰培养检出MRSA ,4例检出MRSE ,临床有效率 76 5 % ,死亡率8 8% ;细菌清除率 6 0 % ;相关肝、肾功损害分别为 2例、4例 ,占 17 6 %。结论 万古霉素治疗老年下呼吸道感染疗效好 ,毒副作用相对较低 。

OBJECTIVE To observe the efficacy and safety of vancomycin for the treatment of lower respiratory tract infection in the elderly patients. METHODS The 34 elderly inpatients with moderate and severe lower respiratory tract infection were treated with vancomycin. RESULTS MRSA was found in 22 patients sputum and MRSE in 4 patients depending on the results of the sputum culture.The total clinical efficacy rate of vancomycin was 76.5%, mortality rate was 8.8% and bacteria elimination rate was 60%. 17.6% Patients showed liver and kidney injury. CONCLUSIONS Vancomycin is effective and with little side effect in treating lower respiratory tract infection in the elderly.