三种抗生素治疗严重烧伤感染的效果对比分析

目的 :比较头孢他啶、头孢哌酮 舒巴坦与亚胺培南 西拉司丁 3种抗生素治疗严重烧伤感染的效果。方法 :选择严重烧伤患者90例 ,随机分为头孢他啶、头孢哌酮 舒巴坦和亚胺培南 西拉司丁 3组 ,每组各 3 0例。头孢他啶和头孢哌酮 舒巴坦组均为每次 1g ,静脉滴注 ,每日 3次 ,疗程 4～ 6天 ;亚胺培南 西拉司丁组每次 0 5g ,静脉滴注 ,每日 3次 ,疗程 4～ 6天。所有患者创面均做分泌物细菌培养、菌种鉴定和药敏试验。结果 :头孢他啶、头孢哌酮 舒巴坦及亚胺培南 西拉司丁组有效率分别为 60 0 %、73 3 %及93 3 % ;共培养细菌 2 0 0株 ,其中以铜绿假单胞菌 ( 3 0 5 % )和金黄色葡萄球菌 ( 2 2 0 % )最为常见。所有革兰阴性杆菌对头孢他啶、头孢哌酮 舒巴坦和亚胺培南 西拉司丁的敏感率分别为 69 0 %、76 0 %与 94 0 % ,所有革兰阳性球菌对头孢他啶、头孢哌酮 舒巴坦和亚胺培南 西拉司丁的敏感率分别为 68 0 %、70 0 %与 94 0 %。结论 :严重烧伤感染患者选择亚胺培南 西拉司丁的治疗效果优于头孢他啶和头孢哌酮 舒巴坦 ,亚胺培南 西拉司丁可作为治疗严重烧伤感染的首选药物

Efficacies of three antibiotics in treatment of infections following severe burn

Objective:To evaluate the efficacies of Ceftazidime (CAZ),Cefoperzone sulbactam (CPZ-SB) and Imipenem cilastatin (IPM-CS) in treatment of systemic infection after major burns.Methods:A total of 90 patients with major burn was enrolled in this study and were randomly allocated to CAZ group (n=30),CPZ-SB group (n=30) and IPM-CS group (n=30).CAZ and CPZ-SB were administered intravenously three times a day for 4 to 6 days,at a daily dose of 3.0 g.The dosage of IPM-CS was 0.5 g 3 times a day for 4 to 6 days.Secretion samples from the 90 burn patients were collected for determination of bacteria and their resistance against antibiotics with routine methods.Results:The response rates to CAZ,CPZ-SB and IPM-CS were 60.0%,73.3% and 93.3% respectively.Two hundred strains of bacteria were isolated with pesudomonas aeruginosa (30.5%) and staphylococcus (22.0%) as the dominators.The sensitivity of CAZ,CPZ-SB and IPM-CS against gram-negative bacilli were 69.0%,76.0% and 94.0% respectively;whereas their sensitivity against gram-positive cocci were 68.0%,70.0% and 94.0% respectively.Conclusions:The efficacy of IPM-CS in the treatment of systemic infection after severe burn was more prominent than CAZ and CPZ-SB.Thus,IPM-CS could be the first choice for management of systemic infection following severe burn.