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1.
目的探讨在抗结核标准治疗方案中使用利奈唑胺代替乙胺丁醇方案治疗药物敏感肺结核的效果。方法将2018年1月-2020年7月在盘锦市传染病医院就诊的43例药物敏感肺结核患者随机分为对照组和利奈唑胺组。对照组给予标准抗结核方案治疗。利奈唑胺组使用利奈唑胺替代标准抗结核治疗方案中的乙胺丁醇进行治疗。比较两组的治疗效果、治疗期间不同时间点痰结核分支杆菌培养转阴率及不良反应发生情况。结果治疗6个月后,利奈唑胺组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗2周、4周和8周,利奈唑胺组痰结核分支杆菌培养转阴率均高于对照组,差异均有统计学意义(P<0.05)。从治疗12周开始,两组间痰结核分支杆菌培养转阴率差异均无统计学意义(P>0.05)。两组治疗期间各不良反应发生情况差异均无统计学意义(P>0.05)。结论综合治疗方案、安全性和耐药性三方面考虑,短期使用利奈唑胺代替抗结核标准治疗方案中的乙胺丁醇,治疗药物敏感肺结核的效果优于抗结核标准治疗方案,且并不会增加不良反应的发生,值得借鉴。  相似文献   
2.
Activities of tedizolid and comparators were evaluated against gram-positive isolates responsible for skin and skin structure infections, pneumonia, and bloodstream infections. Non-duplicate gram-positive isolates (8011) were collected from 20 European countries/regions.

Tedizolid (0.12?mg/L) showed similar results of minimum inhibitory concentration required to inhibit the growth of 50% of organisms (MIC50) regardless of pathogen/group or infection type, except for coagulase-negative staphylococci, Enterococcus faecalis, and viridans group streptococci (VGS), against which tedizolid had MIC50 values of 0.06, 0.25, and 0.06?mg/L, respectively. Similar results of tedizolid MIC50 and minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC90) (MIC50/90, 0.12/0.12?mg/L) were obtained against methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus. Tedizolid, linezolid, and daptomycin were active against enterococci. Tedizolid (MIC90, 0.12–0.25?mg/L), ceftaroline (MIC90, 0.12?mg/L), and vancomycin (MIC90, 0.25–0.5?mg/L) had the lowest MIC90 values against Streptococcus pneumoniae and VGS, whereas ceftaroline (MIC90, ≤0.015?mg/L), penicillin (MIC90, ≤0.06?mg/L), ceftriaxone (MIC90, ≤0.06–0.12?mg/L), and tedizolid (MIC90, 0.12?mg/L) were the most potent against β-haemolytic streptococci.

Tedizolid displayed potent activity against gram-positive isolates from Europe, regardless of infection type.  相似文献   

3.
目的:探讨利福霉素钠注射液联合利奈唑胺注射液对重症革兰阳性球菌感染患者炎症反应、血清降钙素原(PCT)水平及不良反应的影响。方法:选取2018年5月至2019年9月商丘市第一人民医院收治的重症革兰阳性球菌感染患者60例作为研究对象,按照随机数字表法分为研究组和对照组,每组30例。对照组患者给予利奈唑胺注射液治疗,研究组患者在对照组的基础上给予利福霉素钠注射液治疗。比较两组患者的临床疗效、炎症指标[白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)、白细胞介素1β(IL-1β)及白细胞介素10(IL-10)]水平、血清PCT水平及不良反应发生情况的差异。结果:研究组患者的总有效率明显高于对照组[90.00%(27/30)vs.66.67%(20/30)],差异有统计学意义(P<0.05)。治疗后,两组患者血清WBC、CRP及IL-1β水平均较治疗前明显降低,血清IL-10水平较治疗前明显升高;且研究组患者血清WBC、CRP及IL-1β水平明显低于对照组,血清IL-10水平明显高于对照组,上述差异均有统计学意义(P<0.05)。治疗后,两组患者血清PCT水平均较治疗前明显降低,且研究组患者明显低于对照组,差异均有统计学意义(P<0.05)。研究组、对照组患者的不良反应发生率分别为23.33%(7/30)、26.67%(8/30),差异无统计学意义(P>0.05)。结论:利福霉素钠注射液联合利奈唑胺注射液治疗重症革兰阳性球菌感染的临床效果显著,能够有效降低患者血清PCT水平,改善炎症反应,缓解感染症状,具有一定的临床应用价值。  相似文献   
4.
Linezolid is an antibiotic increasingly used for treatment of resistant Gram-positive infections, which blocks bacterial proteosythesis through direct inhibition of mitochondrial ribosomes. The most common adverse effects of linezolid include gastrointestinal symtoms, peripheral neuropathy, bone marrow depression and lactic acidosis.Here we present a rare case of a 9-year-old female, a survivor of acute lymphoblastic leukemia (ALL) and a hematopoietic stem cell transplant (HSCT), who developed life-threatening lactic acidosis with vomiting, impaired consciousness and Kussmaul breathing after 51 days of intravenous linezolid administration due to mycobacterial infection. She fully recovered after drug discontinuation and normalization of the plasma levels.We conclude that plasma lactate concentrations should be monitored closely during any linezolid treatment, particularly in patients with hepatic or renal dysfunction.  相似文献   
5.
Introduction: Linezolid is an oxazolidinone antibiotic active against Gram-positive bacteria, and is most commonly used to treat life-threatening infections in critically ill patients. The pharmacokinetics of linezolid are profoundly altered in critically ill patients, partly due to decreased function of vital organs, and partly because life-sustaining drugs and devices may change the extent of its excretion.

Areas covered: This article is summarizes key changes in the pharmacokinetics of linezolid in critically ill patients. The changes summarized are clinically relevant and may serve as rationale for dosing recommendations in this particular population.

Expert opinion: While absorption and penetration of linezolid to tissues are not significantly changed in critically ill patients, protein binding of linezolid is decreased, volume of distribution increased, and metabolism may be inhibited leading to non-linear kinetics of elimination; these changes are responsible for high inter-individual variability of linezolid plasma concentrations, which requires therapeutic plasma monitoring and choice of continuous venous infusion as the administration method. Acute renal or liver failure decrease clearance of linezolid, but renal replacement therapy is capable of restoring clearance back to normal, obviating the need for dosage adjustment. More population pharmacokinetic studies are necessary which will identify and quantify the influence of various factors on clearance and plasma concentrations of linezolid in critically ill patients.  相似文献   
6.
目的:比较利奈唑胺与万古霉素治疗老年人医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的疗效和安全性。方法57例老年医院获得性MRSA肺炎患者随机分成利奈唑胺组(29例)与万古霉素组(28例),疗程结束后比较两组临床有效率、细菌学清除率及不良反应情况。结果利奈唑胺组临床有效率75.9%,万古霉素组67.9%,两组差异无统计学意义(P>0.05)。利奈唑胺组血小板减少发生率20.7%,用药前后的差异有统计学意义(P<0.05);万古霉素组肾功能损害发生率14.2%。结论利奈唑胺治疗老年人医院获得性肺炎临床疗效与万古霉素相仿,但其不良反应相对轻微。  相似文献   
7.
IntroductionAims of this study were (a) to assess the development ratio of hyponatremia during treatment with linezolid and (b) to evaluate the relationship between the risk of hyponatremia and linezolid exposure and patient background.MethodClinical data including linezolid serum concentrations and serum sodium values were collected at Toyama University Hospital and Kyorin University Hospital. Data from 89 patients were used for the analysis, and a nadir serum sodium level ≤130 mmol/L during the treatment with linezolid was defined as hyponatremia. Mann-Whitney's U test was used to evaluate the effects of the area under the time-concentration curve (AUC) of linezolid at the nadir sodium level, clinical characteristics (e.g. laboratory data), and baseline serum sodium levels on the development of hyponatremia.ResultsThe hyponatremia was occurred in 21 of 89 patients (23.6%). Data are compared for baseline and nadir serum sodium levels of patients with and without hyponatremia. In both groups, nadir serum sodium levels were significantly different from those of the baseline values (P < 0.05). The values of AUC0-12, accumulated AUC, baseline serum sodium levels and age were significantly different between patients with and without hyponatremia (P < 0.05).ConclusionsLinezolid exposure, age, and baseline sodium levels were detected as the risk factors for linezolid-related hyponatremia. Our findings suggest that regular monitoring of serum sodium levels is desirable during treatment with linezolid, especially for the elderly and patients with low serum sodium levels before the start of linezolid administration.  相似文献   
8.
Linezolid is an oxazolidinone antibiotic. Linezolid-associated lactic acidosis has been reported in 6.8% of linezolid-treated patients. Lactic acidosis is associated with poor clinical outcomes, with high blood lactate levels resulting in organ dysfunction and mortality. This case report describes the development of lactic acidosis in a 64-year-old Chinese woman who had received 33 days of treatment with antituberculosis drugs and 28 days of treatment with oral linezolid for tuberculous meningitis. Severe lactic acidosis was reversed by withdrawing antituberculosis drugs and using continuous venovenous hemodiafiltration (CVVH). When the patient's condition was stable, she was transferred to the infectious disease department, and antituberculosis drugs, with the exception of linezolid, were reintroduced. This did not result in recurrence of lactic acidosis. The causal relationship between lactic acidosis and linezolid was categorized as ‘probable’ on the Adverse Drug Reaction Probability Scale. This case demonstrates that CVVH has potential as an alternative to discontinuation of linezolid alone for rapid reversal of linezolid-associated severe lactic acidosis.  相似文献   
9.
Linezolid is an oxazolidinone antimicrobial agent often used to treat multidrug-resistant Gram-positive bacterial infections. The common adverse reactions of linezolid are diarrhea, nausea, headache and bone marrow suppression, and so on. Here, we report the first case of teeth discoloration induced by linezolid linked with extrinsic discoloration in China Mainland. This case report highlights a rare adverse reactions of a commonly used antibiotic.  相似文献   
10.

Introduction

There is an urgent need for new anti-tuberculosis (TB) drugs and optimization of current TB treatment. Moxifloxacin and linezolid are valuable options for the treatment of drug-resistant TB; however, it is crucial to find a dose at which these drugs not only show high efficacy but also suppress the development of further drug resistance.

Methods

Activity of moxifloxacin and linezolid against Mycobacterium tuberculosis was studied in the hollow-fiber infection model system in log-phase growth under neutral pH and slow growth in an acidic environment. Doses that achieved maximum bacterial kill while suppressing the emergence of drug resistance were determined. Through Monte Carlo simulations the quantitative output of this in vitro study was bridged to the human patient population to inform optimal dosage regimens while accounting for clinical minimum inhibitory concentration (MIC) distributions.

Results and Discussion

Moxifloxacin activity was significantly decreased in an acidified environment. The loss of activity was compensated by accumulation of the drug in TB lung lesions; therefore, moderate efficacy can be expected. Moxifloxacin 800 mg/day is the dose that most likely leads to resistance suppression while exerting maximum bacterial kill. Linezolid demonstrated very good activity even at a reduced pH. Linezolid 900 mg once-daily (QD) is likely to achieve a maximum killing effect and prevent the emergence of drug resistance; 600 mg QD in a robust drug regimen may have similar potential.  相似文献   
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