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奥马环素治疗严重嗜肺军团菌肺炎合并多器官功能障碍:一例报告。

Omadacycline for the treatment of severe Legionella pneumophila pneumonia complicated with multiple organ dysfunction: a case report.

机构信息

Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, Hunan, China; Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

Department of Respirology & Critical care medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Diagn Microbiol Infect Dis. 2024 Dec;110(4):116553. doi: 10.1016/j.diagmicrobio.2024.116553. Epub 2024 Oct 10.

Abstract

Omadacycline is a novel tetracycline antibiotic that has a strong in vitro antibacterial activity against atypical pathogen such as Legionella. It is approved for the treatment of adults with community-acquired bacterial pneumonia, including Legionella pneumonia. However, clinical data on the use of omadacycline in Legionella pneumonia is limited. In the present paper, we report a case of severe pneumonia induced by Legionella pneumophila (L.pneumophila) presenting with septic shock and multiple organ dysfunction including lung, liver and kidney. With omadacycline treaetment, inflammation indices of the patient markedly decreased, and the patient significantly improved with multiple organ dysfunction and was discharged from home. Due to its strong antibacterial activity against L.pneumophila, good safety profile and no dosage adjustment in patients with severe hepatic or renal impairment, omadacycline can be considered as an optimal treatment strategies for severe infections by such special pathogen. Whereas, more case reports are needed to support this conclusion.

摘要

奥马环素是一种新型的四环素类抗生素,对军团菌等非典型病原体具有强大的体外抗菌活性。它已被批准用于治疗成人获得性细菌性肺炎,包括军团菌肺炎。然而,奥马环素在军团菌肺炎中的临床应用数据有限。在本研究中,我们报告了一例由嗜肺军团菌(L.pneumophila)引起的严重肺炎,该患者表现为感染性休克和多器官功能障碍,包括肺、肝和肾。使用奥马环素治疗后,患者的炎症指标明显下降,多器官功能障碍显著改善,患者出院回家。由于奥马环素对嗜肺军团菌具有强大的抗菌活性,安全性良好,且在严重肝或肾功能损害的患者中无需调整剂量,因此奥马环素可被视为治疗此类特殊病原体引起的严重感染的最佳治疗策略。然而,还需要更多的病例报告来支持这一结论。

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