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头孢哌酮钠舒巴坦钠治疗血液病合并严重感染的疗效与安全性 阪神感染研究组

[Efficacy and safety of cefbuperazone in severe infections complicating hematologic diseases Hanshin Infection Study Group].

作者信息

Kageyama T, Ohyabu H, Masaoka T, Shibata H, Nagai K, Kitani T, Horiuchi A, Kawagoe H, Yasunaga K, Yonezawa T

机构信息

Second Department of Internal Medicine, Osaka Medical College.

出版信息

Jpn J Antibiot. 1988 Mar;41(3):312-21.

PMID:3043032
Abstract

Cefbuperazone (CBPZ) was administered to patients with severe infections complicating hematologic diseases to assess its efficacy and safety under such clinical conditions. Primary diseases in this series of 78 cases included; acute leukemia in 41 cases, chronic leukemia in 6 cases, other leukemia in 9 cases, malignant lymphoma in 13 cases, multiple myeloma in 3 cases, aplastic anemia in 5 cases and 1 other case. Types of infection included sepsis; proven or suspected, in 59 cases, pulmonary infection in 8 cases, upper respiratory infection in 5 cases, and other cases. CBPZ was infused by an intravenous drip method at a dosage of 4-8 g daily. Patients' ages ranged from 14 to 85 years. Clinical response to the CBPZ regimen was excellent in 24 cases, good in 22 cases, fair in 2 cases, and poor in 30 cases. Thus the overall efficacy rate (percentage of cases showing an excellent or good response) was 59.0%. Efficacy rates for individual types of infection were: documented sepsis 16.7%, suspected sepsis 58.5%, lower respiratory infection 62.5%, and upper respiratory infection 100%. CBPZ also proved to be effective in 61.0% of cases with a neutrophil count of less than 500/mm3 prior to therapy. Side effects encountered were diarrhea in 1 case, gastric discomfort in 1 case and hepatic dysfunction in 5 cases. These side effects, however, were not dose-related, and none were serious. These results indicate that CBPZ has a high therapeutic efficacy even in patient with compromised immunodefenses.

摘要

将头孢哌酮钠舒巴坦钠(CBPZ)用于患有血液系统疾病并发严重感染的患者,以评估其在这种临床情况下的疗效和安全性。该系列78例患者的原发性疾病包括:急性白血病41例、慢性白血病6例、其他白血病9例、恶性淋巴瘤13例、多发性骨髓瘤3例、再生障碍性贫血5例以及其他1例。感染类型包括:确诊或疑似败血症59例、肺部感染8例、上呼吸道感染5例以及其他病例。CBPZ通过静脉滴注法给药,每日剂量为4 - 8克。患者年龄在14岁至85岁之间。对CBPZ治疗方案的临床反应为:优24例、良22例、中2例、差30例。因此,总有效率(显示优或良反应的病例百分比)为59.0%。各类型感染的有效率分别为:确诊败血症16.7%、疑似败血症58.5%、下呼吸道感染62.5%、上呼吸道感染100%。在治疗前中性粒细胞计数低于500/mm³的病例中,CBPZ在61.0%的病例中也被证明有效。出现的副作用为:腹泻1例、胃部不适1例和肝功能障碍5例。然而,这些副作用与剂量无关,且均不严重。这些结果表明,即使在免疫防御功能受损的患者中,CBPZ也具有较高的治疗效果。

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