萆薢分清丸联合左氧氟沙星在多重耐药菌尿路感染中的治疗效果
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摘要
目的了解萆薢分清丸联合左氧氟沙星针剂对于多重耐药细菌所致尿路感染的临床疗效。方法选取在急诊内科住院的尿路感染患者。以第1次尿液培养阳性,致病菌株为革兰阴性杆菌或革兰阳性球菌的68例患者为研究对象。其中男30例,女38例,年龄(67.9±14.6)岁。观察组以口服萆薢分清丸(6 g,1天2次)联合左氧氟沙星(100 m L,1天2次)静脉滴注;对照组单纯静脉滴注左氧氟沙星(100 m L,1天2次)治疗。两组治疗周期均为7 d。结果 68例培养阳性患者中,革兰阴性菌46株,其中产超广谱β内酰胺酶的多重耐药菌株30株,革兰阳性菌30株,其中甲氧西林耐药者9株及肠球菌10株。药敏试验结果显示,萆薢分清丸联合左氧氟沙星对多重耐药细菌所致下尿路感染的总有效率为78.2%(18/23),细菌学总有效率为73.9%(17/23),与对照组比较(总有效率为45.0%,细菌学总有效率为25.0%)均差异有统计学意义(P<0.05)。未发生与药物相关的严重不良事件。结论急诊病人常见的尿路感染病原菌中多重耐药细菌比例高,萆薢分清丸联合左氧氟沙星用于治疗多重耐药菌引起的尿路感染疗效良好。
Objective To assess the efficacy of " Bi xie fen qing wan" combined with Levofloxacin injection in patients with urinary tract infections( UTIs) caused by multidrug resistant( MDR) bacteria. Methods The patients came from our emergency ward. 68 patients with gram-negative bacilli or gram-positive cocci in the first results of urine culture were further evaluated. Among them,30 cases were male and 38 cases were female. The average age was(67. 9± 14. 6) year old. The experimental group was given " Bi xie fen qing wan" 6 g oral twice a day( Bid) combined with Levofloxacin( Lailixin) intravenous drip 100 m L Bid,the control group was given Lailixin only,7 days for a course of treatment. Results In the 68 patients,there were 46 strains of gram-negative bacilli including 30 strains of multidrug resistant bacteria producing extended spectrum lactamases( ESBLs) and 30 strains of gram-positive cocci including methicillin resistant staphylococcus aureus 9 strains,enterococcus 10 strains. The susceptibility of MDR bacteria to " Bi xie fen qing wan" with Levofloxacin injection was calculated. The clinical effective rate was 78. 2%(18/23) and the bacteriological effective rate is 73. 9%(17/23). Compared with the control group( the clinical efficacy 45. 0% and the therapeutic efficacy 25. 0%),there were statistical differences( P < 0. 05). No drug-related serious adverse events were found. Conclusion MDR bacteria in the UTIs of emergency critical patients is common. " Bi xie fen qing wan" with Levofloxacin injection for treatment of UTIs caused by MDR bacteria is effective.
Objective To assess the efficacy of " Bi xie fen qing wan" combined with Levofloxacin injection in patients with urinary tract infections( UTIs) caused by multidrug resistant( MDR) bacteria. Methods The patients came from our emergency ward. 68 patients with gram-negative bacilli or gram-positive cocci in the first results of urine culture were further evaluated. Among them,30 cases were male and 38 cases were female. The average age was(67. 9± 14. 6) year old. The experimental group was given " Bi xie fen qing wan" 6 g oral twice a day( Bid) combined with Levofloxacin( Lailixin) intravenous drip 100 m L Bid,the control group was given Lailixin only,7 days for a course of treatment. Results In the 68 patients,there were 46 strains of gram-negative bacilli including 30 strains of multidrug resistant bacteria producing extended spectrum lactamases( ESBLs) and 30 strains of gram-positive cocci including methicillin resistant staphylococcus aureus 9 strains,enterococcus 10 strains. The susceptibility of MDR bacteria to " Bi xie fen qing wan" with Levofloxacin injection was calculated. The clinical effective rate was 78. 2%(18/23) and the bacteriological effective rate is 73. 9%(17/23). Compared with the control group( the clinical efficacy 45. 0% and the therapeutic efficacy 25. 0%),there were statistical differences( P < 0. 05). No drug-related serious adverse events were found. Conclusion MDR bacteria in the UTIs of emergency critical patients is common. " Bi xie fen qing wan" with Levofloxacin injection for treatment of UTIs caused by MDR bacteria is effective.
引文
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[3]张慧娟,杨海,廖少羽.多重耐药菌感染危险因素分析及防控对策[J].河北医药,2014,43(6):931-932.
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[7]黄海辉,张要元,任振义,等.左氧氟沙星500mg片日1次治疗下呼吸道感染和泌尿道感染的非对照、开放、多中心临床研究[J].中国感染与化疗杂志,2010,10(4):248-257.
[8]高杨.左氧氟沙星序贯疗法治疗尿路感染可行性观察[J].中国医药科学,2012,2(9):90-91.
[9]李雪梅,郭蔚.头孢地尼治疗尿路感染疗效分析[J].中国临床保健杂志,2008,11(6):609-610.
[10]邢跃文.中西药合用治疗反复性尿路感染临床研究[J].中国临床保健杂志,2005,8(2):161-161.
[2]葛芳,黄丽晴,毛美琴.多重耐药菌感染的危险因素与防控措施[J].中国消毒学杂志,2017,34(3)292-294.
[3]张慧娟,杨海,廖少羽.多重耐药菌感染危险因素分析及防控对策[J].河北医药,2014,43(6):931-932.
[4]JEPSON RG,WILLIAMS G,CRAIG JC.Cranberries for preventing urinary tract infections[J].Cochrane Database Syst Rev,2012,10(5):190-194.
[5]伍月红,方锦霞.萆薢的药理作用与临床应用[J].广东药学,2005,15(3):69-72.
[6]徐丹斌,张大权,林津.左氧氟沙星注射液治疗泌尿生殖系感染的安全性分折[J].中国伤残医学,2013,21(9):259-260.
[7]黄海辉,张要元,任振义,等.左氧氟沙星500mg片日1次治疗下呼吸道感染和泌尿道感染的非对照、开放、多中心临床研究[J].中国感染与化疗杂志,2010,10(4):248-257.
[8]高杨.左氧氟沙星序贯疗法治疗尿路感染可行性观察[J].中国医药科学,2012,2(9):90-91.
[9]李雪梅,郭蔚.头孢地尼治疗尿路感染疗效分析[J].中国临床保健杂志,2008,11(6):609-610.
[10]邢跃文.中西药合用治疗反复性尿路感染临床研究[J].中国临床保健杂志,2005,8(2):161-161.