摘要
目的探讨替考拉宁个体化治疗重症革兰阳性菌感染的临床疗效及安全性。方法按照随机数字法将2019年1月至2020年2月皖北煤电集团总医院收治的60例重症革兰阳性菌感染患者分为对照组与观察组,每组各30例。对照组患者按照替考拉宁药品说明书给药,观察组患者在药代动力学指导下个体化给药。采用高效液相色谱法(HPLC)监测两组第3、6剂谷浓度,计算目标谷浓度达标率;观察两组第1、4天的体温、白细胞(WBC)、C反应蛋白(CRP)水平;比较两组的临床疗效及安全性指标。结果观察组第6剂的谷浓度、谷浓度达标率均明显高于对照组(P<0.05)。观察组的治愈率及总有效率均明显高于对照组(P<0.05);第4天,两组的WBC、CRP水平均明显低于第1天(P<0.05),观察组的WBC水平均明显低于对照组(P<0.05)。对照组与观察组之间的病死率、不良反应发生率比较差异均无统计学意义(P>0.05)。结论替考拉宁个体化治疗重症革兰阳性菌感染的临床疗效明显,安全性高;采用HPLC进行治疗药物监测准确、可靠。
Objective To investigate the clinical efficacy and safety of teicoplanin individualized treatment in severe Gram positive(G+)bacterial infection.Methods Sixty patients with severe G+bacterial infection treated in this hospital from January 2019 to February 2020 were divided into the control group and the observation group according to the random number method,30 cases in each group.The patients in the control group were given the medication according to the drug instructions of teicoplanin,while the patients in the observation group received the individualized medication under the guidance of pharmacokinetics.The high performance liquid chromatography(HPLC)was used to monitor the valley concentration of the third and sixth dose in the two groups,and the reaching standard rate of target valley concentration was calculated.The body temperature,WBC and CRP levels on 1,4 d were observed in the two groups.The clinical efficacy and security indexes were compared between the two groups.Results The valley concentration,reaching standard rate of valley concentration of the sixth dose in the observation group were significantly higher than those in the control group(P<0.05).The cure rate and total effective rate of the observation group were significantly higher than those in the control group(P<0.05).The levels of WBC and CRP on 4 d in the two groups were significantly lower than those on 1 d(P<0.05),and the WBC level of the observation group was significantly lower than that of the control group(P<0.05).There was no statistically significant difference in the mortality rate and incidence rate of adverse reactions between the control group and observation group(P>0.05).Conclusion The teicoplanin individualized treatment in severe G+bacterial infection has obvious clinical efficacy and high safety.Adopting HPLC for monitoring the treatment drugs is accurate and reliable.
作者
姚惠
汪正宇
张清文
耿晶
周雅丽
YAO Hui;WANG Zhengyu;ZHANG Qingwen;GENG Jing;ZHOU Yali(Department of Pharmacy,Wanbei Coal-Electricity Group General Hospital,Suzhou,Anhui 23400,China)
出处
《重庆医学》
CAS
2020年第20期3404-3407,共4页
Chongqing medicine
基金
中国药理学会药物研发与合理应用专项任务(2017-64)。
