Wang Kaifei, Hu Ye, Duan Zhimei, Fu Han, Hu Xingshuo, Zhao Ying, Wen Ruoxuan, Li Lina, Xie Fei
College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, People's Republic of China.
Infect Drug Resist. 2023 May 23;16:3233-3242. doi: 10.2147/IDR.S406799. eCollection 2023.
has been well recognized as an important cause of community-acquired pneumonia (CAP), with non-specific characteristics and poor prognosis. In severe CAP (SCAP) guidelines, β-lactam combined with macrolides or fluoroquinolones therapy was recommended, but the efficacy is not satisfactory due to the continued spread of antimicrobial resistance. Contezolid is a new representative of oxazolidinones in clinical development, but no relevant reports have been reported for the treatment of SCAP. This was the first report of a patient with SCAP who was successfully treated with contezolid combined with other antibiotics and rehabilitation exercise.
A 44-year-old woman with high blood pressure and diabetes was admitted to our hospital owing to cough, sputum, wheezing for 2 weeks, and aggravation for 2 days. The bronchoscopic alveolar lavage and microorganism-Rapid On Site Evaluation (BAL-mROSE) was used to get pathological data, which were positive for , in line with blood cultures. During hospitalization, the patient received endotracheal intubation for assisted breathing and anti-infective therapy, including meropenem, linezolid, teicoplanin and tazocin successively. Finally, contezolid obtained excellent result, with platelet recovery to normal levels and significant improvement in pulmonary imaging. Meanwhile, the patient's swallowing disorder improved after continuous rehabilitation exercise. After discharge, she received contezolid consolidation therapy for 1 week and was free of complaints during the 30-day follow-up without any special treatment for SCAP.
Treatment with contezolid combined with other antibiotics and rehabilitation exercise for SCAP has shown remarkable efficacy and good safety; hence, this regimen is a promising treatment strategy for this fatal disease.
已被公认为社区获得性肺炎（CAP）的重要病因，具有非特异性特征且预后较差。在重症CAP（SCAP）指南中，推荐β-内酰胺类联合大环内酯类或氟喹诺酮类治疗，但由于抗菌药物耐药性的持续传播，疗效并不令人满意。康替唑胺是临床开发中恶唑烷酮类的新代表，但尚未有其治疗SCAP的相关报道。这是首例成功使用康替唑胺联合其他抗生素及康复锻炼治疗SCAP患者的报告。
一名44岁患有高血压和糖尿病的女性因咳嗽、咳痰、喘息2周，加重2天入院。采用支气管肺泡灌洗及微生物快速现场评估（BAL-mROSE）获取病理数据，结果为阳性，与血培养结果相符。住院期间，患者接受气管插管辅助呼吸及抗感染治疗，先后使用美罗培南、利奈唑胺、替考拉宁和他唑巴坦。最终，康替唑胺取得了良好效果，血小板恢复至正常水平，肺部影像学明显改善。同时，经过持续康复锻炼，患者吞咽障碍有所改善。出院后，她接受了1周的康替唑胺巩固治疗，在30天随访期间无不适主诉，未针对SCAP进行任何特殊治疗。
康替唑胺联合其他抗生素及康复锻炼治疗SCAP已显示出显著疗效和良好安全性；因此，该治疗方案是治疗这种致命疾病的一种有前景的策略。
