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日本成人用阿贝卡星抗耐甲氧西林金黄色葡萄球菌(MRSA)药物的评估。

Evaluation of arbekacin anti-MRSA agents for adult in Japan.

作者信息

Hamada Yukihiro, Tamura Kazuyoshi, Koyama Ikumi, Seki Megumi, Yago Kazuo, Sunakawa Keisuke, Kuroyama Masakazu

机构信息

Department of Pharmacy, Kitasato University East Hospital.

出版信息

Jpn J Antibiot. 2012 Aug;65(4):221-34.

Abstract

There are a limited number of reports that compare the clinical efficacy of anti-MRSA agents such as arbekacin (ABK), vancomycin (VCM), teicoplanin (TEIC) and linezolid (LZD). There is a tendency for these four agents to show variation in the inflammatory response parameters, in C-reactive protein (CRP) and in white blood cell count (WBC), depending on the administration period. There was no significant difference among the agents in analysis of variance (ANOVA) in the group of days 1-3 (p = 0.0536) but there was some significant difference in the group of days 4-7, as well as days 8-14 (p < 0.001, p < 0.01) in relative variation rate of CRP. Furthermore, we compared in more detail the groups of LZD, VCM and ABK, with a significant decrease of CRP, each of which showed more decrease in comparison with the group of TEIC in the period days 4-7 (p < 0.01). We took 1-hr serum level after days 3-4, with the ABK treatment as the peak concentration (C(peak)). Having made nonlinear logistic regression analysis of CRP and C(peak)/MIC, we concluded that the decrease rate estimable by early inflammatory effect could be decreased to some 40%, assuming that C(peak)/MIC shows the high value within 4 days after ABK treatment.

摘要

比较阿贝卡星(ABK)、万古霉素(VCM)、替考拉宁(TEIC)和利奈唑胺(LZD)等抗耐甲氧西林金黄色葡萄球菌(MRSA)药物临床疗效的报告数量有限。根据给药期不同,这四种药物在炎症反应参数、C反应蛋白(CRP)和白细胞计数(WBC)方面呈现出变化趋势。在第1 - 3天的组中,各药物在方差分析(ANOVA)中无显著差异(p = 0.0536),但在第4 - 7天的组以及第8 - 14天的组中,CRP相对变化率存在一些显著差异(p < 0.001,p < 0.01)。此外,我们更详细地比较了LZD、VCM和ABK组,在第4 - 7天期间,这三组的CRP均显著下降,与TEIC组相比,每组下降幅度更大(p < 0.01)。在第3 - 4天后采集1小时血清水平,以ABK治疗时的峰值浓度(C(peak))为准。对CRP和C(peak)/MIC进行非线性逻辑回归分析后,我们得出结论:假设ABK治疗后4天内C(peak)/MIC显示为高值,那么通过早期炎症效应可估计的下降率可降至约40%。

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