哌拉西林/他唑巴坦用于重症脓毒症经验性抗感染治疗的疗效观察

目的 观察哌拉西林/他唑巴坦(4∶1)用于ICU重症脓毒症患者经验性抗感染治疗的临床疗效.方法 60例重症脓毒症患者随机分为治疗组和对照组,各30例,在同样给予液体复苏等其他相同治疗外,治疗组给予哌拉西林/他唑巴坦(4∶1)、对照组给予头孢噻肟均静脉滴注,分别进行经验性抗感染治疗72 h后,比较炎症指标、APACHEⅡ评分的变化,并评价临床疗效及其安全性.结果 治疗组较对照组无论在炎症指标白细胞计数、超敏C反应蛋白、前降钙素还是APACHEⅡ评分的改善方面均占优势；治疗组和对照组总痊愈率和有效率分别为76.7％和60.0％、90.0％和76.7％,两组比较差异均有统计学意义(P＜0.05)；哌拉西林/他唑巴坦组未出现严重不良反应.结论 哌拉西林/他唑巴坦(4∶1)可作为重症脓毒症患者经验性抗感染治疗的一种广谱、安全有效的抗菌药物.

Clinical efficacy of piperacillin/tazobactam in primary empirical treatment of infections in patients with severe sepsis

OBJECTIVE To study the clinical effect of piperacillin/tazobactam on the primary empirical anti-infectious treatment of severe sepsis in ICU.METHODS A total of 60 patients with severe sepsis were randomly divided into piperacillin/tazobactam treatment group(30 cases) and cefotaxime sodium treatment group(30 cases).The inflammatory markers,APACHE II scores,clinical effect and safety were compared between the two groups 72 hours after treatment.RESULTS The inflammatory indicators and APACHEⅡ scores in piperacillin/tazobactam treatment group were all better improved than in the cefotaxime sodium group,and the total cure rates and efficacy rates in the piperacillin/tazobactam group and the cefotaxime sodium group were 76.7%% and 60%,and 90.0% and 76.7%,respectively,and the differences between the two groups were statistically significant(P<0.05).There were no serious side effects in the piperacillin/tazobactam treatment group.CONCLUSION Piperacillin/tazobactam is a broad-spectrum,safe and effective antibiotic for primary empirical anti-infectious treatment of severe sepsis.