Colardyn F, Gala J L, Verschraegen G, Wauters G, Vogelaers D, Dive A, Claeys G, Magis A, Vandercam B, Mahieu P
Department of Intensive Care, University Hospital, Gent, Belgium.
Rev Infect Dis. 1991 May-Jun;13 Suppl 7:S640-4. doi: 10.1093/clinids/13.supplement_7.s640.
An open, comparative, randomized study was performed in two medical intensive care units to compare the efficacy of the combination of aztreonam and either cloxacillin or oxacillin [(cl)oxacillin] with that of the combination of tobramycin and a cephalosporin. Of the 92 patients who were included in the study, 76 were evaluable. All patients suffered from severe, mostly pulmonary, infections and received ventilatory support. The aztreonam combination yielded an 80% rate of clinical cure; mortality was 15%. Use of the aminoglycoside combination resulted in a 51% rate of clinical cure; mortality was 23%. The difference in cure rate between the two combinations was statistically significant. Adverse effects were negligible in patients who received the aztreonam combination, and superinfection was seen in only 2%. Of the patients who received the aminoglycoside combination, 20% developed a superinfection and 11% developed a new renal insufficiency. Therefore, the combination of aztreonam and (cl)oxacillin is a valuable alternative to the combination of an aminoglycoside and a cephalosporin.
在两个医学重症监护病房进行了一项开放性、比较性、随机研究，以比较氨曲南与氯唑西林或苯唑西林（[氯（苯）唑西林]）联合用药与妥布霉素和头孢菌素联合用药的疗效。纳入研究的92例患者中，76例可进行评估。所有患者均患有严重感染，主要为肺部感染，并接受通气支持。氨曲南联合用药的临床治愈率为80%；死亡率为15%。使用氨基糖苷类联合用药的临床治愈率为51%；死亡率为23%。两种联合用药的治愈率差异具有统计学意义。接受氨曲南联合用药的患者不良反应可忽略不计，仅2%发生二重感染。接受氨基糖苷类联合用药的患者中，20%发生二重感染，11%出现新的肾功能不全。因此，氨曲南与（氯）苯唑西林联合用药是氨基糖苷类与头孢菌素联合用药的一种有价值的替代方案。
