亚胺培南-西司他丁钠治疗重症细菌感染的临床观察
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[摘要] 目的：探讨亚胺培南-西司他丁钠治疗重症细菌感染的临床疗效与安全性。方法：68例重症感染患者随机分为观察组和对照组，每组各34例。在对症处理与支持治疗的基础上，观察组予以亚胺培南-西司他丁钠1.0 g，ivgtt，q8 h～q12 h；对照组予以头孢噻肟钠2.0～6.0 g，ivgtt，q12 h。疗程均4～14 d，观察临床疗效与病原菌清除情况，监测不良反应。结果：观察组与对照组总有效率分别为88.24%、61.76%，细菌清除率分别为82.35%、59.62%，两组比较差异均有统计学意义(均P<0.05)；而不良反应发生率比较差异无统计学意义(P>0.05)。结论：早期使用亚胺培南-西司他丁钠治疗重症感染能迅速清除致病菌，促使病变转归，不良反应少或轻微，可作为早期治疗重症细菌感染的推荐药物。
[关键词] 亚胺培南-西司他丁钠；头孢噻肟钠；重症感染；降阶梯治疗
[中图分类号] R453.2[文献标识码]A [文章编号]1673-7210(2011)03(b)-079-02
Clinical observation on treating severe bacterial infection by Imipenem and Cilastatin Sodium
CAI Ran
Zhuozhou Municipal Hospital, Hebei Province, Zhuozhou 072750, China
[Abstract] Objective: To explore the clinical efficacy and safety of treating severe bacterial infection by Imipenem and Cilastatin Sodium (IM/CI). Methods: 68 patients with severe infection were randomly divided into two groups, and 34 cases in each group. On the basis of symptomatic treatment and supportive care, patients in observation group were given IM/CI, 1.0 g, ivgtt, q8 h-q12 h, yet patients in control group were given Cefotaxime Sodium, 2.0-6.0 g, ivgtt, q12 h. Course of treatment was 4-14 d. Researchers were observed clinical efficacy, clearance of pathogens, and monitored of adverse reactions. Results: The total effective rate in observation group and control group were 88.24% and 61.76% respectively, the bacterial clearance rates were 82.35% and 59.62% respectively, and there were statistically significant in the indicators (all P<0.05), yet there was no statistical difference in two groups in adverse reaction(P>0.05). Conclusion: Early use of IM/CI in the treatment of severe infections can rapidly clear the bacteria, promote patients’ cure, and fewer and minor adverse reactions, and IM/CI can be used as recommended drugs in the early stage of severe bacterial infection.
[Key words] Imipenem and Cilastatin Sodium; Cefotaxime Sodium; Severe Infection; De-Escalation Therapy
亚胺培南为新型碳青霉烯类抗生素，具有广谱的抗菌活性，对革兰阳性、阴性的需氧和厌氧菌均具有较强的抗菌作用，又有β-内酰胺酶抑制作用；西司他丁为特异性二肽酶抑制剂，能阻断亚胺培南在肾脏内的代谢，使亚胺培南免受水解破坏，从而保持亚胺培南在体内的活性[1]。目前，亚胺培南-西司他丁钠(Imipenem and Cilastatin Sodium, IM/CI)主要用于多种病原体所致和需氧/厌氧菌导致的严重感染和广谱耐药菌感染的经验性治疗[2] ......
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