头孢曲松钠、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦在肾移植围术期预防细菌感染的比较研究

目的比较头孢曲松钠(罗氏芬)、头孢哌酮-舒巴坦(舒普深)、哌拉西林-他唑巴坦(特治星)预防肾移植围术期细菌感染的有效性和安全性。方法根据肾移植术后预防感染抗生素种类将241例肾移植患者分三组,头孢曲松钠组(2gqd×7d)132例,头孢哌酮-舒巴坦组(1gtid×5d)36例,哌拉西林-他唑巴坦组(4.5gbid×5d)73例。观察三组细菌感染发生率、副作用。结果头孢曲松钠组感染发生率18.2%,头孢哌酮-舒巴坦组感染率2.7%,哌拉西林-他唑巴坦组1.37%;头孢曲松钠组6例感染患者予头孢曲松钠2gbid,除1例合并克柔假丝酵母菌感染死亡外,其余均治愈;而头孢哌酮-舒巴坦组术后1例出现肺部感染,感染率2.7%,改亚胺培南-西司他丁(泰能)治愈;哌拉西林-他唑巴坦组1例感染患者剂量加至4.5gtid后治愈;三组均无明显副作用。结论头孢曲松钠、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦均是广谱强效抗菌制剂,在肾移植围术期预防感染疗效确切,头孢哌酮-舒巴坦、哌拉西林-他唑巴坦作为联合制剂,比头孢曲松钠有更好的抗感染疗效和较低的感染率。

Comparative Study between Three Antibioticses (Cerftriaxone, Cefoperazonesulbactam, Piperacillin-tazobactam) and the Bacterial Infection during Perioperation of Renal Transplantation

Objective To compare the efficacy and safety of three antibioticses ,Cerftriaxone,Cefoperazone-sulbactam,Piperacillin-tazobactam in preventing bacterial infection during perioperation of renal transplantation.Methods 241 patients were divided into three groups according to antibiotic species,132 patients(Cerflriaxone group)were treated with Rocephin(2g qd for 7d),36 patients(Cefoperazone-sulbactam group)were treated with Cefoperazone-sulbactam(1 g tid for 5d)and 73 patients(Piperacillin-tazobactam group)were treated withPiperacillin-tazobactam (4.5g bid for 5d).Side effect and the bacterial infection incidence of all patients were observed.Results The rate of infection was 18.2%in Cerflriaxone group.2.7%inCefoperazone-sulbactam group and 1.37%in Piperacillin-tazobactam group;5 infected patients in Cerflriaxone group were cured after changed to Sulperazon,another case died of infection of Candida Krusei;4 infected patients in Sulperazon group A were cured after increased to Sulperazon 2g bid;Only 1 infected patients in Piperacillin-tazobactam group are cured after changed to Piperacillin-tazobactam 4.5g Tid.the side effect was very low in all groups.Conclusion Three antibiotics were the broad-spectrum antibiotics,It was safety and efficacy in the prevention of bacterial infection during the perioperation of renal transplantation.In addition,Cefoperazone-sulbactam and Piperacillin-tazobactam which were composite antibiotics,had lower rate of bacterial infection than Cerftriaxone