Wang Xiao-Xia, Ma Cheng-Tai, Jiang Yan-Xia, Ge Yun-Jie, Liu Fa-Yun, Xu Wen-Gang
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.
World J Clin Cases. 2021 Oct 16;9(29):8694-8701. doi: 10.12998/wjcc.v9.i29.8694.
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.
To investigate the therapeutic effects of different antibiotics in elderly patients with respiratory tract infection.
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.
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).
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.
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。
探讨不同抗生素对老年呼吸道感染患者的治疗效果。
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。
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)。
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。