亚胺培南治疗老年重症下呼吸道感染56例临床分析

目的评价亚胺培南/西司他丁钠盐治疗老年重症下呼吸道感染的疗效、细菌耐药及安全性。方法采用回顾性研究,用亚胺培南/西司他丁钠盐治疗呼吸重症监护室(RICU)老年重症下呼吸道感染56例,观察疗效、细菌耐药及安全性。结果用药后临床有效率、临床痊愈率、细菌阴转率和细菌清除率依次为91.2％、82.4％、76％、73.8％;102株细菌高敏率、敏感率和耐药率分别为72.4％、79.4％、20.6％,出现不良反应13例,其中4例腹泻、6例并发真菌感染,1例肠道难辩梭状芽孢杆菌感染,未发现其它副作用。结论亚胺培南/西司他丁钠盐是一个安全、有效的治疗老年重症下呼吸道感染的抗菌药物,但因耐药菌株也在不断增加,因此应密切监测致病菌耐药性的产生和变化,及时调整治疗方案。

Clinical study of imipenem in treatment of the elderly patients with severe lower respiratory tract infections

OBJECTIVE To evaluate the efficacy and safety and antimicrobial resistance of imipenem/cilastatin (Tienam) for the treatment of elderly patients with seriously lower respiratory tract infection. METHODS A total of 56 patients with seriously lower respiratory tract infection in RICU were treated with imipenem/cilastatin (Tienam)(1.0%～1.5g/d iv q12h or q8h)in an open clinical study. RESULTS The total efficacy rate of imipenem/cilastatin (Tienam) was 91.2%. with cure rate of 76%. Bacteria elimination rates were 73.8%. The hight sensitive rate was 72.4%. The moderate sensitive rate was 23.2%(13/56). CONCLUSION The study shows that imipenem/cilastatin(Tienam) is well tolerated and effective in treating seriously lower respiratory tract infection of elderly patients.