Objective To discuss the curative effect of de-escalation therapy of imipenem/cilastatin for severe pneumonia. Methods 56 cases of patients with severe pneumonia admitted in our hospital from December 2013 to December 2015 were selected and divided into two groups according to the different treatment programs, the control group were treated with con-ventional empirical antibiotics, the experimental group were treated with imipenem/cilastatin, the medications of the two groups were adjusted according to the bacteria monitoring and drug sensitivity results and the curative effects of the two groups were observed. Results The clinical curative effect in the experimental group was better than that in the control group, P<0.05, the clinical effective rate was 82.1% in the experimental group and 57.1% in the control group, the applica-tion day of antibiotics and length of stay in the experimental group were obviously lower than those in the control group, P<0.05, the bacterial eradication rate in the experimental group was obviously higher than that in the control group, (85.71%vs 53.66%), P<0.05. Conclusion Imipenem/Cilastatin, as the initial drug of the de-escalation therapy, in treatment of severe pneumonia can effectively control the disease condition and shorten the course of disease, and the curative effect is definite, and it is worth promotion.%目的：探讨对重症肺炎的降阶梯治疗采取亚胺培南/西司他丁治疗的疗效。方法整群选取56例于2013年12月—2015年12月期间该院接收的重症肺炎患者，根据治疗方案的不同分为对照组与实验组，两组分别给予常规经验性抗生素治疗和亚胺培南/西司他丁治疗，两组再根据细菌学监测和药敏结果调整用药，观察两组疗效。结果实验组较对照组临床疗效显著要优(P<0.05)，临床有效率分别为82.1%、57.1%；实验组抗生素应用天数、住院时间显著低于对照组(P<0.05)；实验组致病菌清除率显著高于对照组(P<0.05)，分别为85.71%、53.66%。结论重症肺炎采用亚胺培南-西司他丁作为降阶梯治疗的起始药物，可有效控制病情，缩短病程，疗效确切，值得推广。
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