替考拉宁与利奈唑胺治疗MRSA感染的临床比较

目的 评价替考拉宁与利奈唑胺随机对照治疗重症监护室MRSA感染患者的疗效和安全性.方法 对68例MRSA重症感染患者进行随机对照开放试验,分为替考拉宁组35例,剂量400mg/次,1次/12 h,3个剂量后,1次/d;利奈唑胺组33例,剂量600mg/次,1次/12 h,均为静脉滴注,疗程14～18 d;比较两组病例的疗效、细菌清除率、用药前后的肝肾功能改变.结果 替考拉宁与利奈唑胺治疗重症MRSA感染的临床有效率为88.6％和90.9％,细菌清除率为86.8％、88.2％,两组结果差异无统计学意义；患者治疗后14 d APACHEⅡ评分分别为(10.17±3.32)、(13.66±5.98)分,替考拉宁组优于利奈唑胺组,差异有统计学意义(P＜0.05);不良反应发生率分别为11.4％和18.2％,替考拉宁组的不良反应发生率小于利奈唑胺组,差异有统计学意义(P＜0.05).结论 替考拉宁和利奈唑胺在治疗MRSA所致重症感染均有良好疗效,替考拉宁的用药安全性更高.

Clinical efficacy of teicoplanin and linezolid for MRSA infections:a comparative study

OBJECTIVE To compare the therapeutic effect and safety of teicoplanin and linezolid used for the treatment of the patients with MRSA infections in ICU.METHODS The open-label control test was performed for 68 patients with MRSA infections was performed,35 cases were treated with teicoplanin for 400mg/per time and 12h once,after 3 doses,once per day;33 patients with MRSA infections were treated with linezolid for 600mg per time,12h once,which were all the intravenous drip with 14-18d a course;the therapeutic effect,bacterial clearance,and APACHEⅡscore before and after the medication between the two groups were compared.RESULTS The clinical effective rates of teicoplanin and linezolid for treatment of severe MRSA infections were 88.6% and 90.9%,respectively(P>0.05),the bacterial clearance rates were 86.8% and 88.2%,respectively the differences were not statistically significant;the APACHEⅡscore of the patients on the 14th day were(10.17±3.32) and(13.66±5.98),respectively,the teicoplanin group was superior to the linezolid group,the difference was statistically significant(P<0.05);the incidence rates of the adverse reactions were 11.4% and 18.2%,the incidence rate of the adverse reactions was lower in the teicoplanin group than in the linezolid group,the difference was statistically significant(P<0.05).CONCLUSION Both teicoplanin and linezolid exhibit a similar clinical efficacy on the treatment of patients with MRSA infections,but the teicoplanin is superior to linezolid in the safety of clinical medication.