加替沙星联合万古霉素治疗肠球菌性泌尿系感染24例

目的探讨加替沙星联合万古霉素治疗肠球菌性泌尿系感染的临床疗效和安全性。 方法住院的肠球菌性泌尿系感染患者48例采用随机配对法平分为对照组和治疗组，对照组给予万古霉素2.0 g·d^-1，静脉滴注，疗程14 d；治疗组给予加替沙星400 mg·d^-1，万古霉素10 g·d^-1，静脉滴注，疗程14 d。比较两组患者的临床疗效和不良反应发生率。结果对照组和治疗组临床治疗有效率分别为91.7%和87.5%(P＞0.05)，粪肠球菌对加替沙星的敏感率为72.7%，肠球菌清除率分别为83.3%和75.0%(P＞0.05)。对照组有3例出现肾功能异常，治疗组不良反应不明显。 结论加替沙星对粪肠球菌较敏感，联用万古霉素治疗肠球菌性泌尿系感染临床疗效良好，同时可减少万古霉素用量，降低不良反应，防止万古霉素耐药肠球菌的发生。

The Effect of Gatifloxacin Combined with Vancomycin in the Treatment of 24 Cases of Entercoccal Infection of the Urinary Tract

Objective To probe into the clinical effectiveness and safety rate of gatifloxacin in combination with vancomycin in the treatment of enterococal infection of the urinary tract. Methods 48 inpatients with enterococal infection of the urinary tract were randomly divided into 2 equal groups with the matched pair method. 24 patients of the control group were given each 2.0 g of vancomycin administered by IV instillation q.d.. 24 patients of the treatment group were given each 400 mg of gatifloxacin and 1.0 g of vancomycin administered by IV instillation q.d.. The course of treatment in both groups lasted 14 d. The clinical effectiveness and incidence of adverse reactions in patients of the 2 groups were compared. Results The clinical effective rates in patients of the control group and the treatment group were 91.7% and 87.5%, respectively ( P > 0.05) .24 of the 33 strains(72.7%) of Enterococcus faecalis were sensitive to gatifloxacin. The elimination rates of enterococcus in patients of the control group and the treatment group were 83.3% and 75.0% ,respectively ( P >0.05). Abnormalities of renal function were shown in 3 patients of the control group. No major adverse reactions were encountered in patients of the treatment group. Conclusion The majority of enterococci, in particular E. faecalis were sensitive to gatifloxacin. The effect of gatifloxacin combined with vancomycin in the treatment of enterococcal infection of the urinary tract was reliable. The dose of vancomycin in the combined therapy could be reduced by 50%, so that adverse reactions could be decreased and tolerance of the enterococcus to vancomycin could be prevented.