去甲万古霉素治疗老年人下呼吸道耐甲氧西林葡萄球菌感染43例临床分析

目的通过对盐酸去甲万古霉素在老年人下呼吸道耐甲氧西林葡萄球菌(MRS)感染疗效和安全性分析,为去甲万古霉素在老年人群中的临床合理应用提供依据。方法观察了43例使用去甲万古霉素治疗的老年患者,并与同期住院30例老年患者采用万古霉素治疗比较,观察其临床疗效,细菌清除率和药物不良反应。结果去甲万古霉素在老年患者中的治愈率为20%,有效率为79%,细菌清除率76.7%,不良反应发生率5.4%;在万古霉素治疗组中分别为23%、80%、80%和6.6%,两组相比无显著性差异(P>0.05)。结论盐酸去甲万古霉素对老年人下呼吸道感染疗效良好,耐受性良好,但对原有肾脏疾病与合并使用多种药物患者,去甲万古霉素应慎用。

Clinical evaluation of norvancomycin on lower respiratory tract infection with methicillin resistant Staphylococcus in elderly patients

Objective To evaluate the susceptibility,clinical efficacy and adverse effects of norvancomycin on lower respiratory tract infections caused by methicillin resistant Staplylococcus(MRS) in elderly patients.Methods Seventy-three elderly patients of MRS lower respiratory tract infections were randomly divided into two groups.Patients(n=43) were administered with domestic norvancomycin in treatment group,0.5g,iv gtt q8h.The control group(n=30) were treated with US made vancomycin 0.5g,iv gtt,q8h.Result In the treatment group,the cure rate was 20%,the effective rate 79%,the bacteria eradication rate 76.7%,and the adverse effect rate 5.4%.Accordingly,the four parameters of the control group were 23%,80%,80% and 6.6% respectively.There was no statistically significant difference between the two groups(P>0.05).Conclusion Norvancomycin was effective,inexpensive and safe in treating MRS infection in elderly patient,but to those patients who had kidney disfunction or had treated by many drugs,norvancomycin should be used carefully.