Greco T
Section of Inflammatory Diseases, Saint Mary's Hospital, Waterbury, Connecticut.
Geriatrics. 1989 Aug;44 Suppl A:28-31.
Pneumonia accounts for 15% of all nosocomial infections, and mortality case rates are as high as 60%. Aspiration of oropharyngeal flora is the most common antecedent to nosocomial pneumonia. Patients with chronic lung disease, depressed levels of consciousness, or who are intubated are at increased risk of developing pneumonia. We conducted two comparative, prospective studies using monotherapy with third-generation cephalosporins--the first comparing cefoperazone with combination therapy, and the second comparing cefoperazone monotherapy with ceftazidime monotherapy--for the treatment of nosocomial pneumonia in mildly to moderately ill patients. We found that both cefoperazone monotherapy and ceftazidime monotherapy were as effective as standard two-drug combinations (clindamycin/gentamicin or cefazolin/gentamicin). When total antibiotic costs were compared, cefoperazone monotherapy was the least expensive regimen.
肺炎占所有医院感染的15%，死亡率高达60%。口咽菌群吸入是医院获得性肺炎最常见的诱因。患有慢性肺部疾病、意识水平低下或接受插管的患者发生肺炎的风险增加。我们进行了两项比较性前瞻性研究，使用第三代头孢菌素单药治疗——第一项比较头孢哌酮与联合治疗，第二项比较头孢哌酮单药治疗与头孢他啶单药治疗——用于治疗轻至中度疾病患者的医院获得性肺炎。我们发现，头孢哌酮单药治疗和头孢他啶单药治疗与标准两药联合治疗（克林霉素/庆大霉素或头孢唑林/庆大霉素）一样有效。在比较总抗生素成本时，头孢哌酮单药治疗是最便宜的治疗方案。
