摘要
目的评价万古霉素、替考拉宁及利奈唑胺治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的有效性、安全性及费用疗效比。方法回顾性收集使用万古霉素、替考拉宁或利奈唑胺的确诊或疑似MRSA感染病例资料,比较各组患者的临床疗效、不良反应发生率及费用疗效比。结果共纳入141例,万古霉素组(45例)、替考拉宁组(48例)及利奈唑胺组(48例)治疗MRSA感染的临床有效率分别为64.44%,66.67%和60.42%(P>0.05);3组用药前后的血清炎症因子(降钙素原及C反应蛋白)降低程度比较差异无统计学意义,但均呈下降趋势;3组的不良反应发生率分别为26.67%(肾损伤占17.78%),16.67%和31.25%(血小板下降占10.42%)(P>0.05);替考拉宁组的费用疗效比明显低于另外2组。结论 3组的临床有效率低可能与用药剂量偏低、负荷剂量不足以及合并感染等多种因素有关,需加大血药谷质量浓度的监测力度,以提高临床治疗有效率。
Objective To evaluate the efficacy,safety and cost-effectiveness ratio of vancomycin,teicoplanin and linezolid in the treatment of methicillin-resistant staphylococcus aureus(MRSA) infection.Methods The data of confirmed or suspected MRSA infection patients who treated with the vancomycin,teicoplanin and linezolid were collected retrospectively.The clinical efficacy,adverse reaction rate and cost-effectiveness ratio of each group were compared.Results A total of 141 cases was included,of which vancomycin group(45 cases),teicoplanin group(48 cases) and linezolid group(48 cases) had clinical efficacy of 64.44%,66.67% and 60.42%,respectively(P>0.05).The levels of serum inflammatory factors(procalcitonin and C-reactive protein) before and after treatment were not statistically different,but all showed a downward trend.The incidence of adverse reactions in the 3 groups was 26.67%(kidney damage accounted for 17.78%),16.67% and 31.25%(platelet decline accounted for 10.42%)(P>0.05).The cost-effectiveness ratio of the teicoplanin group was obviously lower than the other 2 groups.Conclusion The lower clinical efficiency of the 3 groups may be related to various factors such as lower dosage,insufficient loading dose,and multiple infections.It is necessary to promote the therapeutic drug monitoring to improve the efficiency of clinical treatment.
作者
胡萨萨
马瑛
尤海生
董亚琳
王茂义
HU Sasa;MA Ying;YOU Haisheng;DONG Yalin;WANG Maoyi(Department of Pharmacy,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China)
出处
《西北药学杂志》
CAS
2020年第4期595-598,共4页
Northwest Pharmaceutical Journal
基金
陕西省重点研发计划项目(编号:2019SF-197)
陕西省自然科学基础研究计划项目(编号:2014JM4101)。
