Jung B, Chanques G, Ghiba M, Cisse M, Rossel N, Perrigault P-F, Souche B, Jean-Pierre H, Jaber S
Service d'anesthésie-réanimation B, hôpital Saint-Eloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
Ann Fr Anesth Reanim. 2010 May;29(5):354-60. doi: 10.1016/j.annfar.2010.02.002. Epub 2010 Mar 29.
To report our experience of tigecycline use in a medical and surgical intensive care unit. To describe its prescription, microbiology findings, tolerance and efficacy.
Prospective, observational, single center study.
All consecutive patients treated with tigecycline were included. Demography, indication of treatment, bacteriology before, during and in the month after treatment and ICU mortality were collected. The main endpoints were clinical and microbiological efficacy and tolerance.
Twenty-four patients were included. In half of the cases, tigecycline was prescribed in monotherapy for a complicated intra-abdominal infection. Overall tolerance of tigecycline was good. Clinical and microbiological cure was obtained in six cases, not obtained in nine, indeterminate in six cases and not evaluable in the three cases of prophylaxis. During the treatment, four bacteria commonly sensitives were shown to be resistant to tigecycline.
Our pilot study on 24 patients suggests that tigecycline is well tolerated in critically ill patients. Clinical cure in severe infections was compromised in nine patients essentially because of resistant pathogens suggesting its prescription on antibiogram. However, the impact of association or the increasing doses in severe critically ill patients should be evaluated.
报告我们在医疗和外科重症监护病房使用替加环素的经验。描述其处方、微生物学结果、耐受性和疗效。
前瞻性、观察性、单中心研究。
纳入所有连续接受替加环素治疗的患者。收集人口统计学资料、治疗指征、治疗前、治疗期间及治疗后一个月的细菌学情况以及重症监护病房死亡率。主要终点为临床和微生物学疗效及耐受性。
纳入24例患者。半数病例中，替加环素以单药治疗用于复杂性腹腔内感染。替加环素总体耐受性良好。6例获得临床和微生物学治愈，9例未获治愈，6例结果不确定，3例预防性用药病例不可评估。治疗期间，4种通常敏感的细菌显示对替加环素耐药。
我们对24例患者的初步研究表明，替加环素在重症患者中耐受性良好。9例重症感染患者临床治愈受损主要是因为病原体耐药，提示应根据抗菌谱开具处方。然而，应评估联合用药或增加剂量对重症患者的影响。
