头孢哌酮钠舒巴坦联合多西环素治疗医院获得性泛耐药鲍曼不动杆菌肺炎临床对照试验

摘要

Objective:To evaluate the efficacy and safety of cefoperazone-sulbactam combine with doxycycline on extensively drug resistant Acinetobacter baumannii infections in critically ill patients. Methods:A prospective randomized controlled clinical study was performed between patients divided into the experimental group and the controlled group,all in conference with the inclusion and exclusion dimensions,which compares the effects of cefoperazone-sulbactam plus doxycycline with the antibiotics with were useing currently.The clinical and bacteriological efficacy and safety were compared between the experimental group and the control group. Results:Among them, 31 patients were evaluanted,There were 19males and 12 females with a mean age of(65.3±13.3)years, the acute Physiology and Chronic Health Evaluation (APACHE Ⅱ)score was (16.5±4.7).The overall effective rate of the experimental group and the control group.was 68.8%and 53.3%resoectively,the microbioligical clearance rate of the groups were 56.3%and 46.7%resoectively. Conclusions:The combined regimen of cefoperazone-sulbactam and doxycycline is efficacious in the treatment of infections caused by XDRAB.for the slight Infected patients,strengthening the supportive therapy without changing the antibiotics also has acertain effects.%目的：评价头孢哌酮钠舒巴坦联合多西环素治疗医院获得性泛耐药鲍曼不动杆菌（XDRAB）肺炎的安全性及有效性。方法：采用前瞻性随机对照研究，将符合纳入及排除标准的患者随机分为两组：对照组沿用原抗感染方案继续治疗，实验组改用头孢哌酮钠舒巴坦及多西环素联合方案抗感染。收集治疗中及结束时资料。评价临床疗效及微生物学疗效，记录不良反应。结果：31例患者纳入研究，年龄（65.3±13.3）岁，男性19例，女性12例，基线APACHEⅡ评分（16.5±4.7）分，实验组与对照组治疗XDRAB肺炎有效率为68.8%和53.3%，细菌清除率为56.3%和46.7%。结论：头孢哌酮钠舒巴坦联合多西环素治疗XDRAB肺炎有一定的临床疗效，对感染较轻的患者，不更改抗生素加强支持治疗也有一定疗效。