【摘要】 目的 :评价美罗培南 (MEM)治疗重症细菌性感染的疗效和安全性。方法 :以亚胺培南 /西司他丁 (IPM/C)为对照药在肺部感染、腹腔和血行感染的住院患者中进行一项随机对照开放多中心临床研究 ,同时单以MEM治疗医院获得的化脓性脑膜炎病例。结果 :共有 114例可评价病例进入本项研究 ,包括肺部感染 5 4例 ,化脓性腹膜炎 16例、胆道感染 2 1例、败血症2 0例和化脓性脑膜炎 3例。其中接受MEM者 5 8例 (包括非对照研究的 3例化脓性脑膜炎患者 ) ,接受IPM/C者 5 6例。MEM与IPM /C随机对照研究结果 ,总有效率各为 87.3 % ( 4 8/ 5 5 )和 87.5 % ( 4 9/ 5 6) ,治愈率 70 .9% ( 3 9/ 5 5 )和 62 .5 % ( 3 5 /5 6)。细菌清除率MEM组 83 .9% ( 4 7/ 5 6) ,IPM /C组 87.9% ( 5 1/ 5 8)。两组患者的不良反应均少见而轻微 ,呈一过性 ,发生率各为 3 .1% (MEM组 )和 3 .3 % (IPM/C组 ) ;考虑为与药物有关的实验室异常者分别为 6.2 % (MEM组 )和 6.6% (IPM/C组 )。上述结果经统计学分析 ,其差别均无显著性。 3例化脓性脑膜炎患者经MEM治疗后痊愈 1例、显效 2例 ,未发生与药物有关的临床和实验室不良事件。结论 :美罗培南是治疗肺部、腹腔、血行感染重症患者的安全而有效的药物。本药治疗医院获得的化脓性脑膜炎的疗效值得进?更多还原

【Abstract】 To evaluate the efficacy and safety of meropenem(MEM) in the treatment of patients with serious bacterial infections. Methods: A randomized controlled open multicenter study of MEM vs imipenem/cilastatin(IPM/C),was conducted in the treatment of hospitalized patients with pulmonary, intra-abdominal and bloodstream infections as well as MEM administered to three patients with nosocomial purulent meningitis. Results: A total of 114 evaluable patients, including 54 pulmonany infections, 16 purulent peritonitis, 21 cholecystitis and cholangitis, 20 septicemia and 3 meningitis were enrolled in the study. 58 patients of them were treated with MEM including 3 cases of meningitis and 56 treated with IPM/C. The results showed that the total effective rate of MEM and IPM/C were 87.3%(48/55) and 87.5%(49/56), cure rates were 70.9%(39/55) and 62.5%(35/56) respectively. The bacterial eradication rate was 83.9%(47/56) for MEM and 87.9%(51/58) for IPM/C. The adverse reactions in both groups were rare, mild being 3.1%(MEM) and 3.3%(IPM/C), laboratory abnormalities considered to be drug related were 6.2%(MEM) and 6.6%(IPM/C). No significant statistical differences between all the above figures of the two groups. Three cases of meningitis were cure in 1, marked improved in 2 after MEM administered, no drug related adverse events were found. Conclusions: MEM is a well tolerated, effective drug for the treatment of severe cases with pulmonary, intra abdominal and bloodstream infections. The clinical efficacy of MEM in treating nosocomial purulent meningitis is worth of further investigation.更多还原