夫西地酸钠与万古霉素治疗ICU病房耐甲氧西林金黄色葡萄球菌的疗效与安全性研究

目的评价夫西地酸钠与万古霉素治疗ICU病房耐甲氧西林金黄色葡萄球菌(MRSA)的疗效与安全性。方法将2011年1月至2013年1月入住我院ICU病房的MRSA感染病例61例,随机分为2组,对照组34例,给予万古霉素1 g,静脉滴注,2次/d;实验组27例,给予夫西地酸钠0.5 g,静脉滴注,3次/d;两组药溶媒均为0.9%氯化钠注射液100 mL,每次给药时间均>60 min,疗程均为5²0 d,具体根据病情严重程度和患者临床反应而定。比较两组抗菌药物治疗前后的临床疗效、细菌清除率及安全性。结果实验组与对照组的临床有效性、细菌清除率和不良反应发生率分别为81.48%、70.37%、11.11%和85.29%、79.41%、17.65%,两组比较差异均无统计学意义(P均>0.05)。结论夫西地酸钠治疗MRSA感染临床疗效与细菌清除率与万古霉素相当,且不良反应发生率低,因此可用于替代万古霉素用于ICU病房MRSA感染的治疗。

Effect and safety of sodium fusidate and vancomycin in the treatment of methicillin resistant Staphylococcus aureus (MRSA)in ICU ward

Objective To evaluate the efficacy and safety of sodium fusidate and vancomycin in the treatment of methicillin resistant Staphylococcus aureus（MRSA） in ICU.Methods 61 patients admitted to ICU ward of our hos pital from January 2011 to January 2013 were randomly divided into control group （n =34）and treatment group （n =27）.Control group was given vancomycin 1 g,intravenous drip,twice daily;and treatment group was given sodium fusidate 0.5 g,intravenous drip,three times daily.The drug solvent of the two groups was 0.9％ sodium chloride injection 100 mL,and the infusion time was over 60 min,and the course of treatment was 5 ～ 20 d or depended on the severity of clinical response of patient.The total clinical efficiency,the bacterial clearance rate and the incidence of ADR of the two groups were observed and compared.Results The total effective rate,the bacterial clearance rate and the incidence of ADR of the two groups were 81.48％,70.37％,11.11％ and 85.29％,79.41％,17.65.There was no significant difference between the two groups （P ＞ 0.05）.Conclusion Sodium fusidate and vancomycin have similar clinical efficacy and bacterial dearance rates in the treatment of MRSA infections,with less incidence of adverse reactions,it can be used instead of vancomycin in the treatment of MRSA infections in ICU.