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头孢哌酮钠/舒巴坦钠与哌拉西林钠/他唑巴坦钠治疗老年患者呼吸道感染。

Cefoperazone sodium/sulbactam sodium piperacillin sodium/tazobactam sodium for treatment of respiratory tract infection in elderly patients.

作者信息

Wang Xiao-Xia, Ma Cheng-Tai, Jiang Yan-Xia, Ge Yun-Jie, Liu Fa-Yun, Xu Wen-Gang

机构信息

Department of Cadre Health, Qingdao Municipal Hospital, Qingdao 266011, Shandong Province, China.

Department of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266011, Shandong Province, China.

出版信息

World J Clin Cases. 2021 Oct 16;9(29):8694-8701. doi: 10.12998/wjcc.v9.i29.8694.

Abstract

BACKGROUND

Respiratory tract infections in the elderly are difficult to cure and can easily recur, thereby posing a great threat to patient prognosis and quality of life.

AIM

To investigate the therapeutic effects of different antibiotics in elderly patients with respiratory tract infection.

METHODS

Seventy-four elderly patients with respiratory tract infection were randomly allocated to a study ( = 37; treated with cefoperazone sodium/sulbactam sodium) or control ( = 37; treated with piperacillin sodium/tazobactam sodium on the basis of routine symptomatic support) group. Both groups were treated for 7 d. Time to symptom relief (leukocyte recovery; body temperature recovery; cough and sputum disappearance; and rale disappearance time), treatment effect, and laboratory indexes [procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NE)] before and 7 d after treatment and the incidence of adverse reactions were assessed.

RESULTS

In the study group, the time to WBC normalization (6.79 ± 2.09 d), time to body temperature normalization (4.15 ± 1.08 d), time to disappearance of cough and sputum (6.19 ± 1.56 d), and time to disappearance of rales (6.68 ± 1.43 d) were shorter than those of the control group (8.89 ± 2.32 d, 5.81 ± 1.33 d, 8.77 ± 2.11 d, and 8.69 ± 2.12 d, respectively; = 0.000). Total effective rate was higher in the study group (94.59% 75.68%, = 0.022). Serum PCT (12.89 ± 3.96 μg/L), CRP (19.62 ± 6.44 mg/L), WBC (20.61 ± 6.38 × 10/L), and NE (86.14 ± 7.21%) levels of the study group before treatment were similar to those of the control group (14.05 ± 4.11 μg/L, 18.79 ± 5.96 mg/L, 21.21 ± 5.59 × 10/L, and 84.39 ± 6.95%, respectively) with no significant differences ( = 0.220, 0.567, 0.668, and 0.291, respectively). After 7 d of treatment, serum PCT, CRP, WBC, and NE levels in the two groups were lower than those before treatment. Serum PCT (2.01 ± 0.56 μg/L), CRP (3.11 ± 1.02 mg/L), WBC (5.10 ± 1.83 × 10/L), and NE (56.35 ± 7.17%) levels were lower in the study group than in the control group (3.29 ± 0.64 μg/L, 5.67 ± 1.23 mg/L, 8.13 ± 3.01 × 10/L, and 64.22 ± 8.08%, respectively; = 0.000). There was no significant difference in the incidence of adverse reactions between the groups (7.50% 12.50%, = 0.708).

CONCLUSION

Piperacillin sodium/tazobactam sodium is superior to cefoperazone sodium/ sulbactam sodium in the treatment of elderly patients with respiratory tract infection with a similar safety profile.

摘要

背景

老年人呼吸道感染难以治愈且易复发,对患者预后和生活质量构成极大威胁。

目的

探讨不同抗生素对老年呼吸道感染患者的治疗效果。

方法

将74例老年呼吸道感染患者随机分为研究组(n = 37;接受头孢哌酮钠/舒巴坦钠治疗)和对照组(n = 37;在常规对症支持基础上接受哌拉西林钠/他唑巴坦钠治疗)。两组均治疗7天。评估症状缓解时间(白细胞恢复、体温恢复、咳嗽和咳痰消失、啰音消失时间)、治疗效果、治疗前及治疗7天后的实验室指标[降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞百分比(NE)]以及不良反应发生率。

结果

研究组白细胞恢复正常时间(6.79 ± 2.09天)、体温恢复正常时间(4.15 ± 1.08天)、咳嗽和咳痰消失时间(6.19 ± 1.56天)及啰音消失时间(6.68 ± 1.43天)均短于对照组(分别为8.89 ± 2.32天、5.81 ± 1.33天、8.77 ± 2.11天、8.69 ± 2.12天;P = 0.000)。研究组总有效率更高(94.59%对75.68%,P = 0.022)。研究组治疗前血清PCT(12.89 ± 3.96μg/L)、CRP(19.62 ± 6.44mg/L)、WBC(20.61 ± 6.38×10⁹/L)及NE(86.14 ± 7.21%)水平与对照组(分别为14.05 ± 4.11μg/L、18.79 ± 5.96mg/L、21.21 ± 5.59×10⁹/L、84.39 ± 6.95%)相似,差异无统计学意义(分别为P = 0.220、0.567、0.668、0.291)。治疗7天后,两组血清PCT、CRP、WBC及NE水平均低于治疗前。研究组血清PCT(2.01 ± 0.56μg/L)、CRP(3.11 ± 1.02mg/L)、WBC(5.10 ± 1.83×10⁹/L)及NE(56.35 ± 7.17%)水平低于对照组(分别为3.29 ± 0.64μg/L、5.67 ± 1.23mg/L、8.13 ± �.×10⁹/L、64.22 ± 8.08%;P = 0.000)。两组不良反应发生率差异无统计学意义(7.50%对12.50%,P = 0.708)。

结论

在治疗老年呼吸道感染患者方面,哌拉西林钠/他唑巴坦钠优于头孢哌酮钠/舒巴坦钠,且安全性相当。

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