帕尼培南-倍他米隆治疗665例中重度肺部感染疗效与安全性

摘要

目的 评价帕尼培南-倍他米隆治疗中重度肺部感染的临床有效性与安全性.方法 开放性、前瞻性、多中心临床研究.对621例中重度肺部感染患者[社区获得性肺炎(CAP) 345例,医院获得性肺炎(HAP) 230例,呼吸机相关性肺炎(VAP) 46例]静脉滴注帕尼培南-倍他米隆500 mg,1次/6h,7～14d一个疗程,评估治疗结束时的临床疗效和细菌学疗效,记录观察期间出现的不良反应.结果 帕尼培南-倍他米隆治疗中重度肺部感染的临床有效率为84.4％,其中CAP、HAP、VAP的临床有效率分别为91.9％、76.1％、69.6％,中度、重度肺部感染的临床有效率分别为87.5％和82.8％.细菌分离阳性率为54.8％,细菌学清除率为80.9％；对铜绿假单胞菌、肺炎克雷伯杆菌、大肠埃希菌、鲍曼不动杆菌的清除率分别为74.7％、95.6％、89.5％和50.9％.与药物相关的不良反应12例,发生率为1.8％,均为轻度,未予处理,停药后恢复正常.结论 帕尼培南-倍他米隆治疗中重度肺部感染的疗效佳且不良反应发生率低.%Objective To evaluate the clinical efficacy and safety of intravenous panipenembetamipron in the treatment of moderate to severe pulmonary infection.Methods An open,perspective,multicenter clinical trial was conducted.Among the enrolled 665 patients,621 patients with moderate to severe pulmonary infection were treated with intravenous panipenem-betamipron at a dose of 500 mg every 6 hours per day for 7-14 days.Among them,the community acquired pneumonia (CAP),hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP) patients were 55.6％ ( 345/621 ),37.0％ (230/621)and 7.4％ (46/621),respectively.All the adverse events were recorded.Results The overall effective rate of panipenem-betamipron was 84.4％ with CAP of 91.9％,HAP of 76.1％ and VAP of 69.6％.The effective rates in the patients with moderate and severe pulmonary infection were 87.5％ and 82.8％,respectively. Bacterial separation rate was 54.8％ and bacterial eradication rate was 80.9％.Bacterial eradication rates to pseudomonas aeruginosa,pneumobacillus,Escherichia coli.and acinetobacter baumannii were 74.7％,95.6％,89.5％ and 50.9％,respectivdy.The adverse events rate was 1.8％ (12/665).Conclusion Intravenous panipenem-betamipron is effective in treating moderate to severe pulmonary infection with low adverse events rate.