目的 评价头孢吡肟治疗细菌性感染的疗效和安全性.方法 以头孢他啶为对照药,在下呼吸道感染、腹腔、胆道感染、败血症中进行随机对照观察.给药方案为头孢吡肟每次2 g,2次/d,头孢他啶每次2 g,3次/d;治疗尿路感染头孢吡肟每次1 g,2次/d,头孢他啶每次1 g,3次/d;均为静脉滴注,疗程均为7～14 d.结果 头孢吡肟组65例,头孢他啶组64例.头孢毗肟组和头孢他啶组有效率分别为92.3%及90.6%,痊愈率各为72.3%及68.8%,细菌清除率分别为94.9%和87.5%,两组的不良反应发生率均为6%.两组的疗效和安全性经统计学处理无显著差异.头孢吡肟和其他抗菌药物对临床分离菌的体外抗菌活性测定结果显示,头孢吡肟对大肠杆菌、肠杆菌属、克雷伯菌属等肠杆菌科细菌,铜绿假单胞菌等假单胞菌属等革兰阴性杆菌具高度抗菌活性.结论 头孢吡肟治疗敏感菌所致的下呼吸道感染、尿路感染、腹腔、胆道感染、败血症等疗效确切,不良反应少见而轻微.%Objective To evaluate the efficacy and safety of cefepime in the treatment of patients with bacterial infections.Methods A randomized controlled study was conducted in patients with lower respiratory tract infection(LRTI),urinary tract infection(UTI),peritonitis,hepato-biliary infection and septicemia,Dosage regimens were cefepime 2 g bid and ceftazidime 2 g q8h;while cefepime 1 g hid and ceftazidime 1g q8h were given to patients with UTI.Duration of treatment was 7～14 days.Results Six-ty five patients were given cefepime and 64 patients were given ceftazidime.Clinical cure rates and total ef-fective rates were 72.3%,92.3%in the cefepime group,and 68,8%,90.6%in the eeftazidime group respectively.and the corresponding bacterial eradication rates were 94.9%and 87.5%respectively.The adverse reaction rates were 6%in both groups.There were no significant difference in clinicaI cure rates,total effective rates.bacterial eradication rates and adverse reaction rates between the two groups.The re-suits of the in-vitro activity demonstrated that cefepime was highly active against E.coli,Enterobacter spp,Klebsiella spp,other Enterobacteriaceae,P.aeruginosa and other Gram-negative bacilli.Conclusion Ce-fepime is effective and safe in the treatment of LRTI,UTI,peritonitis,hepato-biliary infection and sep-ticemia caused by sensitive pathogens.
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