利奈唑胺临床应用分析

目的观察利奈唑胺的疗效和不良反应,为临床合理使用药物提供参考。方法选择我院2007年9月-2008年10月应用利奈唑胺的住院患者,对50例病例进行分析。结果50例中,革兰阳性球菌培养阳性29例,总有效率62%。医院获得性肺炎35例,其中甲氧西林耐药金黄色葡萄球菌阳性15例,甲氧西林耐药凝固酶阴性葡萄球菌阳性3例,肠球菌阳性1例,有效率为68.4%;皮肤软组织感染9例,其中甲氧西林耐药金黄色葡萄球菌阳性3例,甲氧西林耐药凝固酶阴性葡萄球菌阳性1例,肠球菌阳性1例,有效率为60%;中枢神经系统感染3例,其中甲氧西林耐药凝固酶阴性葡萄球菌阳性2例,肠球菌阳性1例,有效率为33.3%;导管相关性血流感染1例,甲氧西林耐药金黄色葡萄球菌阳性,治愈;肝脓肿1例,无效;发热待查1例,甲氧西林耐药凝固酶阴性葡萄球菌阳性,无效。出现消化道反应(恶心、腹胀、腹泻)5例,黄疸1例,耳鸣1例,皮疹2例。结论利奈唑胺可治疗革兰阳性球菌肺炎、皮肤软组织感染和导管相关性血流感染。本品治疗中枢神经系统感染的疗效尚不确定,不适合肝脓肿和发热待查的经验性治疗。其不良反应较少,对肝脏酶学和血小板有一定的影响。

Clinical application of linezolid

Objective To observe the effect and side effects of linezolid,provide a reference for clinical use.Methods The inpatients treated with linezolid in our hospital from September 2007 to October 2008 were chose,and 50 cases were screened out.Results 29 cases of gram-positive cocci culture-positive were found,and the total effective rate was 62%.Hospital-acquired pneumonia was found in 35 cases with 15 cases of methicillin-resistant Staphyloccus aureus culture-positive,3 cases of methicillin-resistant coagulase-negative Staphylocci culture-positive,1 case of enterococcu-positive,and the effective rate was 68.4%;Skin and soft tissue infection was found in 9 cases with 3 cases of methicillin-resistant Staphyloccus aureus culture-positive,1 cases of methicillin-resistant coagulase-negative Staphylocci culture-positive,1 case of enterococcu-positive,and the effective rate was 60%;Central nervous system infection was found in 3 cases with 2 cases of methicillin-resistant Staphyloccus aureus culture-positive,1 case of enterococcu-positive,and the effective rate was 33.3%;there was a case of Catheter-related bloodstream infection and methicillin-resistant Staphyloccus aureus culture-positive (ineffective).Five cases occurred gastrointestinal reactions,such as nausea,abdominal distension and diarrhea,other side effects including a case of jaundice,a case of tinnitus and 2 cases of skin rash.Conclusion Gram-positive pneumonia,skin and soft tissue infections and catheter-related bloodstream infection can be treated by linezolid.The effect of linezolid on central nervous system infection is uncertain,and the drug is not suitable for empirical treatment of liver abscess and fever of unknown origin.It has fewer side-effects,however,it has a certain impact on liver enzyme and platelet.