哌拉西林／三唑巴坦的临床评价

目的：评价国产哌拉西林／三唑巴坦的疗效和安全性。方法：哌拉西林／三唑巴坦与替卡西林／克拉维酸在下呼吸道腹腔胆道感染中进行随机对照观察，其中治疗组54例，对照组52例；另58例接受哌拉西林／三唑巴坦治疗的下呼吸道、尿路、皮肤软组织感染和败血症例系开放组。治疗下呼吸道、腹腔胆道等感染哌拉西林／三唑巴坦为4．5g q8h静脉滴注，尿路、皮肤软组织感染为4．5g bid静脉滴注，替卡西林／克拉维酸均为每次3．2g q8h静脉滴注。结果：哌拉西林／三唑巴坦治疗下呼吸道感染和腹腔胆道感染的疗效与对照药相仿，但其治疗下呼吸道感染的疗效优于替卡西林／克拉维酸（P＝0．02），细菌清除率两组相仿，两组中均无不良反应者。哌拉西林／三唑巴坦（包括治疗组和开放组）治疗上述感染的总有效率为92．0％（103／112），细菌清除率97．3％（103／111），不良反应发生率为1．8％（2／112），分别为腹泻及ALT升高各1例。结论：国产哌拉西林／三唑巴坦治疗常见性细菌感染疗效确切，不良反应少而轻微，其疗效较替卡西林／克拉维酸相似或略优，安全性与替卡西林／克拉维酸相仿。

Clinical evaluation of piperacillin/tazobactam

Objective: To evaluate the effiacy and safety of piperacillin/tazobactam. Methods: A randomized controlled study was conducted in patients with lower respiratory tract and abdominal and biliary tract infections, 54 patients received piperacillin/tazobactam as treatment group and 52 patients received ticarcillin/clavulanic acid as control group, another 58 patients with lower respiratory tract infections, urinary tract infections, septicemia, skin and soft tissue infections were treated with piperacillin/tazobactam as open group. The dosage of piperacillin/tazobactam was 4.5g q8h in treating lower respiratory tract and abdominal and biliary tract infections, 4.5g bid in treating urinary tract infections and skin and soft tissue infections while the dosage of ticarcillin/clavulanic acid was 3.2g q8h. Results: The effective rate of treatment group in respiratory tract infections and abdominal and biliary tract infections was similar to that of control group, but the clinical efficacy of piperacillin/tazobactam in treating respiratory tract infections was better than that of ticarcillin/clavulanic acid group ( P =0.02). The bacterial eradication rate was similar between two groups. There was no adverse reaction in the two groups. The total effective rate was 92.0% (103/112), the bacterial eradication rate was 97.3% (108/111), incidence of adeverse reactions was 1.8% (2/112), including 1 diarrhea and 1 slight elevation of serum ALT value. Conclusion: The efficacy of domestic piperacillin/tazobactam in treating common bacterial infections was reliable, the adverse reactions was rare and mild. The efficacy of piperacillin/tazobactam is similar to or better than ticarcillin/clavulanic acid, the safety of piperacillin/tazobactam is similar to ticarcillin/clavulanic acid.