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目的对替考拉宁与万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)下呼吸道感染的临床疗效和安全性进行分析。方法回顾性分析2013年6月至2014年12月我院收治的53例MRSA下呼吸道感染患者的临床资料,其中22例应用替考拉宁治疗(替考拉宁组),31例应用万古霉素治疗(万古霉素组);分别对其治疗前后的临床症状、体征、临床疗效、细菌清除情况以及不良反应进行分析,并将临床分离菌分别进行替考拉宁和万古霉素的体外药敏试验。结果替考拉宁组治疗时间平均(9.2±3.1)d,显著性低于万古霉素组的(14.9±3.3)d(P<0.01)。替考拉宁组总有效率为77.3%,万古霉素组为77.4%,两组比较差异无统计学意义(χ2=0.000,P>0.05)。替考拉宁组细菌清除率为72.7%,万古霉素组为83.9%,两组比较差异无统计学意义(χ2=0.972,P>0.05)。药敏试验结果显示替考拉宁和万古霉素对痰液MRSA分离菌均有极强的抗菌活性。替考拉宁组出现与药物很可能和可能有关的不良反发生率为9.1%,万古霉素组为16.1%,两组比较差异无统计学意义(χ2=0.062,P>0.05)。结论替考拉宁和万古霉素治疗MRSA下呼吸道感染疗效均较好,安全性高,但替考拉宁较之万古霉素使用时间更短。
Objective To analyze the clinical efficacy and safety of teicoplanin and vancomycin in the treatment of lower respiratory tract infection with methicillin-resistant Staphylococcus aureus (MRSA). Methods The clinical data of 53 MRSA patients with lower respiratory tract infection in our hospital from June 2013 to December 2014 were analyzed retrospectively. Among them, 22 were treated with teicoplanin (teicoplanin), 31 were treated with vancomycin (Vancomycin group). The clinical symptoms, signs, clinical efficacy, bacterial clearance and adverse reactions before and after treatment were analyzed. The clinical isolates were treated with teicoplanin and vancomycin in vitro Sensitive test. Results The average duration of teicoplanin treatment was (9.2 ± 3.1) days, significantly lower than that of vancomycin (14.9 ± 3.3) days (P <0.01). The total effective rate was 77.3% in the teicoplanin group and 77.4% in the vancomycin group. There was no significant difference between the two groups (χ2 = 0.000, P> 0.05). Bactericidal clearance rate was 72.7% in teicoplanin group and 83.9% in vancomycin group, there was no significant difference between the two groups (χ2 = 0.972, P> 0.05). Susceptibility test results showed that teicoplanin and vancomycin sputum MRSA isolates have a very strong antibacterial activity. There was a 9.1% incidence of adverse reactions in the teicoplanin group, which is likely to be related to the drug, and 16.1% in the vancomycin group. There was no significant difference between the two groups (χ2 = 0.062, P> 0.05). Conclusion Teicoplanin and vancomycin are effective and safe in treating lower respiratory tract infections of MRSA, but teicoplanin is shorter than Vancomycin.