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外科重症监护患者感染的抗生素治疗,特别是美洛西林治疗(作者译)

[Antibiotic therapy of infections in patients under surgical intensive care, in particular with mezlocillin (author's transl)].

作者信息

Haldemann G, Haldemann M, Rieschel H, Weuta H

出版信息

Arzneimittelforschung. 1979;29(12a):1995-9.

PMID:261572
Abstract

Twenty-two patients from our surgical intensive care ward were, after unsuccessful treatment outside, treated with a combination of antibiotics including 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen) as a beta-lactam antibiotic. The infection was cured in 16 and improved in 2 patients. Three cases of infection with Serratia did not respond to treatment and antibacterial efficacy was unassessable in another case. Four patients died of shock lung (2), pulmonary embolism (1) or Candida-induced septicaemia (1) after cure of the infection. The daily dose of mezlocillin was 3 x 5 g, given as an i.v. short-term infusion. Diarrhoea (1) and petechiae (1) were observed as side effects probably attributable to mezlocillin. In none of the patients was a discontinuation of treatment necessary. Owing to its broad spectrum of action (covering both gram-positive and gram-negative microorganisms and anaerobes) and its consistently strong molar action, mezlocillin is well suited as a beta-lactam combination component for intensive care patients. At the end of this study in vitro resistant strains appeared. Therefore mezlocillin with its very valuable properties should be given only to critically selected cases.

摘要

我们外科重症监护病房的22名患者在院外治疗失败后,接受了包括6-[(R)-2-[3-甲基磺酰基-2-氧代-咪唑烷-1-甲酰胺基]-2-苯基-乙酰胺基]-青霉烷酸钠盐(美洛西林,拜朋)作为β-内酰胺类抗生素的联合抗生素治疗。16例感染治愈,2例病情改善。3例沙雷氏菌感染患者治疗无效,另1例的抗菌疗效无法评估。4例患者在感染治愈后死于休克肺(2例)、肺栓塞(1例)或念珠菌引起的败血症(1例)。美洛西林的日剂量为3×5g,通过静脉短期输注给药。观察到腹泻(1例)和瘀点(1例)可能是美洛西林引起的副作用。所有患者均无需停药。由于美洛西林具有广泛的抗菌谱(涵盖革兰氏阳性菌、革兰氏阴性菌和厌氧菌)且其摩尔作用始终很强,它非常适合作为重症监护患者β-内酰胺联合用药的组成部分。在本研究结束时出现了体外耐药菌株。因此,美洛西林尽管具有非常宝贵的特性,但仅应给予经过严格筛选的病例。

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