【摘要】 目的探讨国产头孢哌酮-舒巴坦治疗ICU泛耐药(PRD)鲍曼不动杆菌导致的医院获得性肺炎(HAP)的临床疗效,为合理应用抗菌药物提供指导。方法宜昌市中心医院ICU2010年6月—2011年12月36例痰培养细菌药敏试验提示PDR鲍曼不动杆菌感染HAP患者,使用国产头孢哌酮-舒巴坦3.0g,每6小时1次静脉滴注或2.25 g,每6小时1次静脉滴注(存在肾功能不全时)。疗程至少7 d,治疗结束后,对患者临床疗效、细菌学疗效、不良反应回顾并进行统计学分析。结果 36例患者经治疗后20例临床有效,10例进步,6例无效,总有效率55.5%。15例患者细菌得到清除,清除率为41.6%。平均疗程(14.3±5.6)d,仅4例出现不良反应(4/36),占11.1%。结论根据该院鲍曼不动杆菌分离株的耐药特点,提高头孢哌酮-舒巴坦剂量治疗ICU PDR鲍曼不动杆菌导致的HAP具有一定疗效,且不良反应少。更多还原

【Abstract】 Objective To evaluate the clinical effect of large dose of cefoperazone-sulbactam on hospital-acquired pneumonia(HAP) caused by carbapenem-resistant Acinetobacter baumannii,so as to support the reasonable use of antibacterial agents.MethodsA total of 36 patients in the ICU were confirmed as HAP caused by carbapenem-resistant Acinetobacter baumannii by way of sputum culture and susceptibility testing from June 2010 to December 2011.These patients were treated with cefoperazone-sulbactam 3.0 g or 2.25 g(if renal insufficiency),IV infusion,every 6 hours,for at least 7 days.The clinical efficacy,bacteriological efficacy and adverse reactions were well recorded and analyzed retrospectively.ResultsThe HAP was cured in 20 patients,improved in 10 patients,ineffective in 6 patients after treatment with cefoperazone-sulbactam.The overall efficacy rate was 55.5%.The bacterial pathogen was cleared in 15 of the 36 patients(41.6%).The mean duration of treatment was 14.3 ± 5.6 days.Adverse reactions were observed in only 4 patients(11.1%).ConclusionsHigh dose cefoperazone-sulbactam has showed good therapeutic effect on the HAP caused by carbapenem-resistant Acinetobacter baumannii with few adverse reactions.It may be one of the best choices for the HAP caused by pandrug resistant A.baumannii in ICU.更多还原