Lin Shupeng, Liang Lingfang, Zhang Chenmei, Ye Sheng
37066 Zhejiang University School of Medicine Children's Hospital , Division of Hematology- Oncology, No. 57 Zhugan Road, Hangzhou, CN 310052.
37066 Zhejiang University School of Medicine Children's Hospital , Pediatric Intensive Care Unit, No. 3333 Binsheng Road, Hangzhou, CN 310003.
J Int Med Res. 2020 Jan;48(1):300060518760435. doi: 10.1177/0300060518760435. Epub 2018 Apr 3.
Ventilator-associated pneumonia (VAP) is a life-threatening complication for children who are treated in a paediatric intensive care unit. Tigecycline treatment of children with VAP has not been well studied. This study aimed to describe tigecycline use in children with VAP in a tertiary care hospital.
We conducted a retrospective chart review in a tertiary hospital from May 1, 2012 to May 1, 2017.
Twenty-four children (20 girls) with median age of 8 months (range, 27 days to 6 years and 9 months) were treated with tigecycline. In-hospital mortality was 41.7% (10/24). The primary diagnosis was congenital heart disease (15/24). A total of 70.8% (17/24) of patients received a loading dose (1.5 mg/kg), followed by 1 mg/kg every 12 hours. The median duration of tigecycline therapy was 10.75 days (range, 3–21.5 days). Sulperazone was the most frequently used concomitant antibiotic. Eighteen pathogens were isolated in 16 cases. Tigecycline therapy failed in 41.6% (10/24) of patients and 20.8% (5/24) died. The pathogen was eradicated in 37.5% (6/16) of patients. No serious adverse effects were detected.
Tigecycline combined with other agents as salvage therapy in children with VAP is well tolerated. Our preliminary results show a positive clinical response.
呼吸机相关性肺炎(VAP)是儿科重症监护病房中接受治疗的儿童面临的一种危及生命的并发症。替加环素治疗儿童VAP尚未得到充分研究。本研究旨在描述一家三级医院中替加环素在儿童VAP治疗中的应用情况。
我们对一家三级医院2012年5月1日至2017年5月1日期间的病历进行了回顾性分析。
24名儿童(20名女孩)接受了替加环素治疗,中位年龄为8个月(范围为27天至6岁9个月)。住院死亡率为41.7%(10/24)。主要诊断为先天性心脏病(15/24)。共有70.8%(17/24)的患者接受了负荷剂量(1.5mg/kg),随后每12小时给予1mg/kg。替加环素治疗的中位持续时间为10.75天(范围为3 - 21.5天)。舒普深是最常使用的联合抗生素。16例患者分离出18种病原体。41.6%(10/24)的患者替加环素治疗失败,20.8%(5/24)的患者死亡。37.5%(6/16)的患者病原体被清除。未检测到严重不良反应。
替加环素联合其他药物作为儿童VAP的挽救治疗耐受性良好。我们的初步结果显示出积极的临床反应。