硝呋太尔制霉素阴道软胶囊治疗细菌性阴道炎48例临床观察

目的:观察硝呋太尔制霉素阴道软胶囊治疗细菌性阴道炎的临床疗效和不良反应。方法:将96例细菌性阴道炎患者随机分为2组。治疗组采用硝呋太尔制霉素阴道软胶囊治疗,对照组则采用甲硝唑泡腾片治疗。结果:治疗组的显效率为93.8%,对照组的显效率为72.9%,两组比较,差异有统计学意义(χ2=7.50,P<0.01)。治疗组的总有效率(97.9%)也显著高于对照组的81.25%(χ2=7.14,P<0.01)两组不良反应率比较,差异无统计学意义(P>0.05)。结论:硝呋太尔制霉素阴道软胶囊是一种可供选择的,能用于治疗细菌性阴道炎的阴道局部药物。     

臭氧联合硝呋太尔制霉素阴道软胶囊治疗阴道炎的疗效观察

阴道炎是女性生殖系统炎症,由各种病因引起的多种阴道炎的总称,主要以假丝酵母菌性阴道炎、细菌性阴道炎、滴虫性阴道炎为主。近年来由于导致感染的因素逐渐增多,其发病率亦逐渐升高,导致致病的病原体的种类也越来越多,女性阴道感染多以混合感染为主,单纯应用一种药物治疗很难获得满意疗     

硝呋太尔制霉素阴道软胶囊治疗阴道炎120例临床报道

<正>阴道炎是妇科常见病,不仅患者有明显的不适感,影响生活和工作。临床上常见阴道炎多为念珠菌、阴道细菌、和阴道滴虫等感染引起,我院门诊应用硝呋太尔制霉素阴道软胶囊治疗这三种类型的阴道炎120例,取得良好的临床效果,现报道如下:1资料与方法1.1一般资料     

硝呋太尔制霉素阴道软胶囊治疗孕期外阴阴道假丝酵母菌病的疗效观察

目的:评价国产硝呋太尔制霉素阴道软胶囊治疗孕期外阴阴道假丝酵母菌病的临床疗效和安全性。方法:采用随机盲法平行对照多中心临床实验,国产克霉唑栓为对照药。结果:硝呋太尔制霉素阴道软胶囊治疗孕期外阴阴道假丝酵母菌病的治愈率为85.0%、总有效率96.7%。对照组克霉唑栓的治愈率为76.7%、总有效率86.7%。两组总有效率比较,P<0.05,有显著性差异。结论:硝呋太尔制霉素阴道软胶囊治疗孕期外阴阴道假丝酵母菌病的疗效显著,使用方便,易被孕妇接受,值得临床推广。     

硝呋太尔制霉素阴道软胶囊治疗阴道炎患者的临床疗效分析

目的 探究硝呋太尔制霉素阴道软胶囊治疗阴道炎患者的临床疗效。方法 选取2020年1月至2021年1月我院收治的阴道炎患者150例,随机分为对照组和观察组各75例。对照组行复方莪术油栓治疗,观察组行硝呋太尔制霉素阴道软胶囊治疗。比较两组治疗前后生活质量评分,比较两组病原菌培养阴性时间、瘙痒消失时间、阴道分泌物检查转阴时间,及治疗总有效率及并并发症发生情况。结果 治疗前,两组生活质量评分比较,差异无统计学意义(P>0.05);治疗后,两组生活质量评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组病原菌培养阴性时间、瘙痒消失时间、阴道分泌物检查转阴时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 硝呋太尔制霉素阴道软胶囊辅助治疗阴道炎患者的临床疗效显著,可加速患者阴道分泌物转阴,进一步减轻瘙痒、疼痛等症状,提升生活质量。     

乳酸菌阴道胶囊联合硝呋太尔制霉素阴道软胶囊在念珠菌性阴道炎中的应用价值

目的：分析乳酸菌阴道胶囊联合硝呋太尔制霉素阴道软胶囊在念珠菌性阴道炎中的应用价值。方法：选取2020年1月至2021年12月收治的念珠菌性阴道炎患者66例,按随机数字表法分为观察组和对照组,各33例。对照组予以硝呋太尔制霉素阴道软胶囊治疗,观察组在对照组基础上联合乳酸菌阴道胶囊治疗。对比两组疗效、症状改善时间、炎症介质[白细胞介素-2(IL-2)、白细胞介素-8(IL-8)、白细胞介素-13(IL-13)]水平、微循环情况（毛细血管管径、血流灌注、红细胞聚集率、水肿率）、症状改善情况、不良反应发生情况及复发率。结果：观察组总有效率为96.67%(32/33),高于对照组的75.76%(25/33)(P<0.05);观察组瘙痒、疼痛、烧灼感改善时间短于对照组（P<0.05）;治疗1个疗程后,观察组IL-2、IL-8、IL-13水平低于对照组（P<0.05）;观察组毛细血管管径、血流灌注高于对照组,红细胞聚集率、水肿率低于对照组（P<0.05）;观察组阴道弹性、黏膜、分泌物、湿润度评分高于对照组（P<0.05）;观察组不良反应发生率为6.06%(2/33),低...     

定君生合硝呋太尔制霉素治疗孕期合并VVC的疗效观察

目的:观察定君生(阴道用乳酸杆菌活菌胶囊)联合硝呋太尔制霉素阴道软胶囊治疗孕期合并阴道假丝酵母菌病(VVC)的疗效与安全性。方法 :选取2016年1月～2017年1月我院收治的168例VVC患者作为研究对象,随机分为对照组和研究组各84例。对照组采用硝呋太尔制霉素阴道软胶囊进行治疗,研究组在此基础上联合定君生进行治疗。于治疗前(T1)及停药7d后(T2),评估两组患者的VVC相关症状(白带增多、外阴瘙痒、外阴灼痛、黏膜充血)改善情况,并观察两组的疗效和不良反应发生情况。结果:T2时,两组患者的VVC相关症状评分均较T1时低,且研究组的VVC相关症状评分低于对照组,差异均有统计学意义,P0.05;研究组的总有效率大于对照组,差异有统计学意义,P0.05;两组不良反应发生率相比较,差异无统计学意义,P0.05。结论:定君生联合硝呋太尔制霉素阴道软胶囊治疗孕期合并VVC可显著改善患者的相关症状,提高疗效,且安全性良好。     

妇科中药消炎洗剂联合硝呋太尔制霉素阴道软胶囊治疗霉菌性阴道炎的临床疗效研究

目的 研究妇科中药消炎洗剂联合硝呋太尔制霉素阴道软胶囊治疗霉菌性阴道炎的疗效。方法 选取收治的66例霉菌性阴道炎患者,通过单双抽签方式分为试验组和常规组各33例。常规组接受硝呋太尔制霉素阴道软胶囊治疗,试验组在对照组基础上给予妇科中药消炎洗剂治疗。对比两组治疗前后阴道pH值和血清炎性因子水[白细胞介素-6(IL-6)、白介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)]水平;对比两组疗效、不良反应及复发率。结果 治疗后,两组pH值均降低,乳酸杆菌含量均升高,且试验组pH值显著低于常规组,乳酸杆菌含量显著干预常规组（P<0.05）;两组IL-6、IL-8和TNF-α水平均降低,且试验组小组低于常规组（P<0.05）;试验组疗效高于常规组（P<0.05）;试验组复发率低于常规组（P<0.05）。结论 在硝呋太尔制霉素阴道软胶囊的基础上联合妇科中药消炎洗剂治疗霉菌性阴道炎的临床疗效较高,能有效改善阴道pH和局部炎性因子水平,降低复发率,安全性较高。     

社区妇女滴虫性阴道炎 外阴阴道假丝酵母菌病及细菌性阴道病感染率调查

目的了解惠州市惠城区桥东街道办事处社区妇女滴虫性阴道炎、外阴阴道假丝酵母菌病、细菌性阴道病的感染状况。方法对2010～2011年在惠州市惠城区桥东街道办事处社区卫生服务中心就诊的妇科门诊患者的阴道分泌物检查结果进行回顾性统计分析。结果社区妇女阴道分泌物滴虫性阴道炎检出率为1.1%,外阴阴道假丝酵母菌病检出率为16.7%,细菌性阴道病检出率为14.3%。结论外阴阴道假丝酵母菌病、细菌性阴道病在社区妇女中有较高的发病率,应引起高度重视。     

常见阴道炎病原学检测结果分析

目的通过总结与分析妇科门诊常见阴道炎症检出情况及其相关影响因素,为阴道炎的诊治及预防制订个体化方案。方法收集2012年7月至2014年6月在郑州人民医院妇科门诊因阴道分泌物增多、外阴瘙痒或分泌物有异味就诊的13 072例资料,对妇科检查与阴道分泌物检验结果进行统计学分析。结果共检出三种常见阴道炎4 895例,总检出率为37.45%。其中,外阴阴道假丝酵母菌病检出率为12.83%,细菌性阴道病检出率为22.15%,滴虫性阴道炎检出率为2.46%。三组间差异比较具有统计学意义(P<0.05)。在细菌性阴道病中,≥50岁组检出率最高,为30.69%;其次为20~29岁组,检出率为25.47%,比较其他三个年龄组,差异具有统计学意义(P<0.05)。在外阴阴道假丝酵母菌病中,30~39岁组检出率最高,为26.45%,明显高于其他年龄组,差异比较具有统计学意义(P<0.05)。在滴虫性阴道炎中,≥50岁组的检出率最高,为5.37%,明显高于50岁以下患者,差异比较具有统计学意义(P<0.05)。结论细菌性阴道病是最常见的阴道炎。阴道炎均好发于性生活活跃的育龄期女性。阴道炎的发生与阴道内外环境有关。     

乳酸菌阴道胶囊纠正中晚期妊娠霉菌性阴道炎患者阴道菌群紊乱的效果

目的探讨乳酸菌阴道胶囊纠正中晚期妊娠霉菌性阴道炎患者阴道菌群紊乱的效果。方法选取我院2018年9月至2019年5月收治的58例中晚期妊娠霉菌性阴道炎患者作为研究对象,随机将其分为观察组(29例,克霉唑栓+乳酸菌阴道胶囊)与对照组(29例,克霉唑栓)。比较两组患者的治疗效果。结果治疗7 d后,观察组阴道pH值低于对照组,差异具有统计学意义(P<0.05);两组的不良反应发生率、复发率比较,差异无统计学意义(P>0.05);观察组菌落≥1/2面积率、阴道菌群纠正率高于对照组,差异具有统计学意义(P<0.05)。结论乳酸菌阴道胶囊联合克霉唑栓治疗方案可有效纠正中晚期妊娠霉菌性阴道炎患者的阴道菌群紊乱,保证母婴安全,值得临床推广应用。     

氟康唑与克霉唑阴道栓联合应用方案治疗外阴阴道假丝酵母菌病的临床评价

目的:探究氟康唑与克霉唑阴道栓联合应用方案治疗外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)的临床疗效及不良反应,为临床医师选择合理用药方案提供参考。方法:选取沈阳国际旅行卫生保健中心于2017年1月至2019年12月诊治的102例VVC患者为研究对象,依据随机数字表法,随机将研究对象分为两组,对照组和观察组(每组51例),对照组给予克霉唑阴道栓治疗,观察组采用氟康唑与克霉唑阴道栓联合应用方案治疗,比较两组患者的临床治疗效果和不良反应发生率。结果:观察组患者的临床治疗总有效率为96.08%,高于对照组(84.31%),P<0.05;观察组患者的不良反应发生率为5.88%,高于对照组(1.96%),但组间比较差异无统计学意义,P>0.05。结论:在VVC的治疗中,氟康唑联合克霉唑阴道栓治疗效果较单药治疗理想,且未明显增加不良反应发生率,有效且安全,值得推荐。     

Inappropriate initial antibiotic treatment for complicated skin and soft tissue infections in hospitalized patients: incidence and associated factors

We analyzed 525 hospitalized adults treated with intravenous antibiotic(s) for complicated skin and soft tissue infections (cSSTIs) to assess incidence of, and risk factors associated with, inappropriate initial antibiotic treatment (IIAT). IIAT was given to 22.5% of enrolled patients. The rate of IIAT did not vary by type of facility (academic versus community) but was significantly higher in rural than urban hospitals (38.9% versus 21.3%, P = 0.02). Pathogens were exclusively gram-positive in 68% of patients, exclusively gram-negative in 13%, and mixed in 19%. Staphylococcus aureus was the most frequently isolated pathogen (in 65%), 54% of which were methicillin-resistant. Significant independent risk factors for IIAT were: admission to a rural hospital (odds ratio = 2.34; 95% confidence interval: 1.06–5.19), dialysis treatment (3.86; 1.15–12.93), cancer other than non-melanoma skin cancer (5.23; 1.78–15.36), and infection with gram-negative (3.43; 1.79–6.60) or mixed (4.52; 2.62–7.78) pathogens. IIAT for cSSTIs was relatively frequent in these hospitalized patients, especially those with selected risk factors.     

Community-associated methicillin-resistant and methicillin-sensitive Staphylococcus aureus: skin and soft tissue infections in Hong Kong

This prospective study assessed the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among patients with purulent skin and soft tissue infections (SSTIs) in Hong Kong. Among 298 patients with SSTIs, 10.4% (13/125) of all S. aureus isolates and 5% (12/241) of all abscesses were attributed to pvl-positive CA-MRSA. Overall, 77% and 69.9% of CA-MRSA and methicillin-sensitive S. aureus (MSSA) were susceptible to erythromycin, 77% and 74.8% to clindamycin, 100% and 97.1% to minocycline, and 100% and 98.1% to rifampin, respectively. Filipino ethnicity was the only clinical and epidemiologic factor significantly associated with CA-MRSA infection (odds ratio, 14.8; 95% confidence interval, 3.3-70.0; P < 0.001). Pulsed-field gel electrophoresis analysis showed that 6 CA-MRSA isolates belonged to the ST30-HKU100 clone, 5 belonged to the ST59-HKU200 clone, and 1 was singleton. Features of HKU100 isolates include SCCmec type IV, agr3, spa t019, and pan-susceptibility to non-beta-lactam antibiotics. In contrast, HKU200 isolates are characterized by having SCCmec type IV or V, agr4, spa t437, and variable non-beta-lactam susceptibility profiles. The major CA-MRSA spa types were shared by a minority of the MSSA.     

Economic outcomes of inappropriate initial antibiotic treatment for complicated skin and soft tissue infections: a multicenter prospective observational study

This study examined economic outcomes associated with inappropriate initial antibiotic treatment (IIAT) in complicated skin and soft tissue infections using data from adults hospitalized and treated with intravenous antibiotic therapy. We specifically analyzed for the subsets of patients infected with methicillin-resistant Staphylococcus aureus (MRSA), with healthcare-associated (HCA) infections, or both. Data from 494 patients (HCA: 360; MRSA:175; MRSA + HCA: 129) showed the overall mean length of stay (LOS) was 7.4 days and 15.0% had the composite economic outcome of any subsequent hospital admissions, emergency department visits, or unscheduled visits related to the study infection. A total of 23.1% of patients had IIAT; after adjustments, these patients had longer LOS than patients without IIAT in the HCA cohort (marginal LOS = 1.39 days, P = 0.03) and the MRSA + HCA cohort (marginal LOS = 2.43 days, P = 0.01) and were significantly more likely to have the composite economic outcome in all study cohorts (odds ratio: overall = 1.79; HCA = 3.09; MRSA = 3.66; MRSA + HCA = 6.92; all P < 0.05).     

Efficacy and safety of daptomycin in Japanese pediatric participants with complicated skin and soft tissue infections or bacteremia caused by gram-positive cocci

IntroductionComplicated skin and soft tissue infections (cSSTIs) and bacteremia caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), are common causes of infection for children worldwide. Here, the safety and efficacy of daptomycin in Japanese pediatric participants are reported.MethodsThis open-label, single-arm phase 2 study (NCT03643952) enrolled Japanese pediatric participants (age 1–17 years) with cSSTI or bacteremia caused by gram-positive cocci. Participants received age-adjusted doses of intravenous daptomycin for 5 to up to 14 days (cSSTI) or 5 to up to 42 days (bacteremia). The primary objective was safety and tolerability; efficacy among participants with infections caused by MRSA was a secondary objective.ResultsA total of 18 participants (cSSTI, n = 14; bacteremia, n = 4) were enrolled across 12 study sites in Japan. The most common pathogen was S. aureus (15/18 [83.3%]), including methicillin-susceptible and -resistant isolates. Adverse events (AE) were reported in 42.9% (6/14) of participants with cSSTI and 100% (4/4) of participants with bacteremia. No deaths, serious AEs, discontinuations of study medication due to an AE, or events of clinical interest occurred in the study. In participants with infections caused by MRSA, 87.5% [7/8] achieved favorable clinical response at test of cure (TOC) visit (cSSTI, 85.7% [6/7]; bacteremia, 100% [1/1]). In this population, favorable microbiological response at TOC was achieved by 71.4% (5/7) of participants with cSSTI and 100% (1/1) of participants with bacteremia.ConclusionsDaptomycin was well tolerated, exhibited a favorable safety profile, and was effective for the treatment of cSSTI or bacteremia in Japanese children.     

头孢地尼与头孢特仑酯随机对照治疗细菌性感染

目的 :以头孢地尼和头孢特仑酯随机对照治疗急性轻中度呼吸道、泌尿道及皮肤软组织感染 ,评价头孢地尼的疗效及安全性。方法 :31例患者接受头孢地尼 10 0～ 2 0 0mg ,每日 3次 ;35例接受头孢特仑酯 10 0～ 2 0 0mg ,每日 3次 ,疗程 7～ 14d。结果 :试验组和对照组痊愈率和有效率分别为 74 .2 %、80 .0 % (P >0 .0 5 )与 96 .8%、97.1% (P >0 .0 5 )。两组的细菌阳性率、清除率分别为 87.1%、85 .7% (P >0 .0 5 )和 96 .3%、93.3% (P >0 .0 5 )。临床分离的 5 7株致病菌对头孢地尼、头孢特仑酯、头孢克肟、头孢克洛、阿莫西林和环丙沙星的敏感率分别为 87.7%、98.2 %、4 7.4 %、82 .5 %、4 3.9%和 6 3.2 % ;头孢地尼与头孢特仑酯、头孢克洛相比差异无显著性 (P >0 .0 5 ) ,但与头孢克肟、阿莫西林和环丙沙星相比差异有显著性 (P <0 .0 5 )。两组不良反应发生率分别为 4 .9%和 9.1% (P >0 .0 5 )。结论 :头孢地尼治疗轻、中度细菌感染安全、有效。     

Diagnostic and therapeutic evaluation of community-acquired methicillin-resistant Staphylococcus Aureus (MRSA) skin and soft tissue infections in the emergency department

Background

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections commonly present as skin and soft-tissue infections (SSTIs). Treatment often includes incision and drainage with or without adjunctive antibiotics. Emergency department (ED) pharmacists wished to provide specific data to emergency physicians to better inform antibiotic choices for patients with SSTIs.

Study Objectives

The objectives of this study were to describe local susceptibility trends of CA-MRSA isolates obtained from patients with SSTIs and describe diagnostic and empiric therapeutic management of CA-MRSA SSTIs among ED health care providers at University of Utah Hospitals and Clinics.

Methods

Susceptibility of all unique CA-MRSA SSTI isolates for 2008 were identified and compiled into an antibiogram. ED providers evaluated their diagnostic and treatment habits using a self-assessment questionnaire, which was verified against charted information documented in the electronic medical records for patients presenting to the ED with a CA-MRSA SSTI.

Results

The ED antibiogram indicated that 57/58 (98%) CA-MRSA SSTI isolates were susceptible to sulfamethoxazole/trimethoprim (SMX/TMP); 50/58 (86%) isolates were susceptible to tetracycline, and 47/58 (81%) isolates were susceptible to clindamycin. Incision and drainage were performed in 23/25 (92%) patient cases, which was consistent with providers’ perceived habits (100%). SMX/TMP monotherapy was preferred among 23/35 (66%) providers, however, SMX/TMP combined with cephalexin was the antibiotic regimen prescribed in 9/22 (41%) patient cases.

Conclusions

Cephalexin was often added to cover for potential cellulitis due to Streptococcus spp., however, the surrounding erythema may simply be an extension of the CA-MRSA infection. Department-specific antibiograms are useful in guiding empiric antibiotic selection and may help providers judiciously prescribe antibiotics only when necessary.     

“桥”式修补术与前盆底重建术治疗阴道前壁脱垂的对比

目的 探讨阴道桥式修补术治疗阴道前壁脱垂的可行性和临床疗效.方法 回顾分析2008年10月-2013年12月在扬州大学附属泰兴医院住院手术治疗的阴道前壁脱垂60例患者的临床资料,其中行阴道前壁桥式缝合术(研究组)32例,前盆底重建术(对照组)28例,分析比较2种术式治疗阴道前壁脱垂的术中及术后情况.结果 2组患者均顺利完成手术.阴道前壁桥式修补术组手术时间(25±1.2) min,术中出血(20.0±3.5) mL,住院费用(8 536.4±2 561.5)元;前盆底重建术组手术时间(38±1.5) min,术中出血(60±5.5) mL,住院费用(10 952.898±2 144.1)元.2组比较,差异有统计学意义(P＜0.05).阴道前壁桥式修补术组住院时间(8.9±3.6)d,复发率(3.1％);前盆底重建术组住院时间(8.9±2.4)d,复发率(3.6％).2组比较,差异无统计学意义(P＞0.05).结论 与前盆底重建术相比,桥式修补术治疗阴道前壁脱垂具有手术时间短、术中出血少、价格低廉易行等优点,值得在基层医院推广应用.     

Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998-2004)

The morbidity and cost for cure associated with skin and soft tissue infections (SSTIs) have recently become more complicated because of the increasing prevalence of multidrug-resistant pathogens associated with this healthcare problem. The SENTRY Antimicrobial Surveillance Program has been monitoring SSTI since 1997, and now presents data from 3 continents over a 7-year period (1998-2004). Isolates were tested by reference broth microdilution methods at a central laboratory using the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards) methods and interpretative criteria. The predominant pathogens included Staphylococcus aureus (ranked 1st in all geographic regions), Pseudomonas aeruginosa, Escherichia coli, and Enterococcus spp. A considerable variation in the methicillin (oxacillin)-resistant S. aureus rate was noted between countries and continents, with the overall rate highest in North America (35.9%) compared with Latin America (29.4%) and Europe (22.8%). Vancomycin-resistant Enterococcus spp. increased in Europe (4.1%) and North America (6.2%) during the period, but remained low and relatively unchanged in Latin America. Among the P. aeruginosa isolates tested, susceptibility to imipenem was much lower in Latin America (65.3%) compared with the other regions (80.7-88.7%), and resistance being associated with an increase in metallo-beta-lactamase-producing strains in Latin America and in some European countries. Multidrug-resistant strains of P. aeruginosa were also more of a concern in Latin America (24.7%) compared with Europe (10.8%) or North America (3.2%). Latin America also had the highest occurrence of extended-spectrum beta-lactamase-producing isolates among E. coli (15.1%) and Klebsiella spp. (48.0%) when compared with other regions. Continued surveillance of pathogen prevalence and antimicrobial resistance patterns should provide information that is important to improve empiric care particularly in the hospital environment.