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硫酸黏菌素和硫酸多黏菌素 B 在治疗碳青霉烯类耐药肠杆菌科细菌引起的肺炎中的真实世界数据。

Real-world data on the effects of colistin sulfate and polymyxin B sulfate in the treatment of pneumonia induced by CR-GNB.

机构信息

Department of Critical Care Medicine, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China .

Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China .

出版信息

J Infect Dev Ctries. 2024 Jul 29;18(7):1050-1057. doi: 10.3855/jidc.18887.

Abstract

INTRODUCTION

The aim of this study was to compare the efficacy and safety of colistin sulfate (CS) with polymyxin B sulfate (PMB) in the treatment of pneumonia induced by carbapenem-resistant Gram-negative bacteria (CR-GNB).

METHODOLOGY

Patients diagnosed with pneumonia caused by CR-GNB and admitted to the intensive care unit (ICU) from January 2020 to September 2022 were enrolled in this study. The patients were divided into the CS group and the PMB group according to their medication regimens. Group-wise demographic data, clinical efficacy, prognosis, and adverse events were analyzed and compared.

RESULTS

A total of 120 patients (68 in the CS group and 52 in the PMB group) with pneumonia were included in the study. The majority of the pathogens were CR-Acinetobacter baumannii, followed by CR-Klebsiella pneumoniae, and CR-Pseudomonas aeruginosa. The clinical response rates in the CS and PMB groups after treatment were 62.0% and 65.4%, bacterial clearances were 44.0% and 36.5%, 28-day mortality rates were 16.0% and 13.5%, respectively; no significant differences between the two treatments were found. Nevertheless, the adverse effects were significantly less common in the CS group than in the PMB group, especially when treatments were administered intravenously.

CONCLUSIONS

CS, a novel polymyxin E formulation, is as effective as PMB in treating pneumonia induced by CR-GNB while causing less side effects.

摘要

简介

本研究旨在比较硫酸黏菌素(CS)与硫酸多黏菌素 B(PMB)在治疗碳青霉烯类耐药革兰氏阴性菌(CR-GNB)引起的肺炎中的疗效和安全性。

方法

本研究纳入了 2020 年 1 月至 2022 年 9 月期间因 CR-GNB 引起肺炎并入住重症监护病房(ICU)的患者。根据用药方案将患者分为 CS 组和 PMB 组。对两组患者的人口统计学数据、临床疗效、预后和不良事件进行分析和比较。

结果

本研究共纳入 120 例肺炎患者(CS 组 68 例,PMB 组 52 例)。主要病原体为 CR-鲍曼不动杆菌,其次为 CR-肺炎克雷伯菌和 CR-铜绿假单胞菌。CS 组和 PMB 组治疗后的临床反应率分别为 62.0%和 65.4%,细菌清除率分别为 44.0%和 36.5%,28 天死亡率分别为 16.0%和 13.5%;两组治疗无显著差异。然而,CS 组的不良反应明显少于 PMB 组,尤其是静脉给药时。

结论

新型黏菌素 E 制剂 CS 与 PMB 治疗 CR-GNB 引起的肺炎疗效相当,但不良反应较少。

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