Guo Qingli, Wei Yifei, Zhao Qiongrui, Zhang Wenping, Lv Pin, Zhou Zhimin, Wang Shanmei
Department of Clinical Laboratory, Xuchang People's Hospital, Xuchang, Henan, People's Republic of China.
Department of Clinical Laboratory, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China.
Infect Drug Resist. 2025 Jun 17;18:3013-3021. doi: 10.2147/IDR.S515207. eCollection 2025.
The rising incidence of carbapenem-resistant Acinetobacter baumannii (CRAB) poses challenges in Intensive Care Unit (ICU) settings. Eravacycline, the first fluorocycline antibiotic introduced globally, is increasingly utilized for CRAB-related infections. This study compares eravacycline with tigecycline for CRAB pneumonia in ICU patients.
This retrospective study analyzed 65 ICU patients with CRAB pneumonia treated at Henan Provincial People's Hospital from September 2023 to March 2024; the clinical efficacy and adverse reactions of eravacycline and tigecycline as target therapies were compared.
Both CRAB pneumonia cohorts exhibited more than 50% co-infection rates, predominantly and . Multiple organ dysfunction syndrome (MODS) incidence was significantly higher in the eravacycline group (45.5% vs 15.5%, P<0.05). Prior to target-drug administration, patients in the eravacycline group showed a longer duration of antibiotic therapy (19.79 ± 9.97 days vs 14.25 ± 7.98 days; P<0.05). Similarly, the median hospital stay was longer in the eravacycline group [27 (19.50, 39.00) days] versus the tigecycline group [19 (14.00, 29.00) days]. After the index culture, the median time to antibiotic initiation was longer in the eravacycline group than in the tigecycline group (6.52 ± 5.03 days vs 4.09 ± 3.14 days; P < 0.05). The 30-day mortality rate was lower in the eravacycline group than in the tigecycline group (15.2% vs 25.0%). Notably, no deaths occurred among eravacycline-treated patients who received infectious disease specialist consultations. Infection symptom resolution and cure rates did not differ significantly between the two groups.
Eravacycline demonstrated non-inferior efficacy to tigecycline in CRAB pneumonia treatment, with a favorable safety profile. Prompt consultation with infectious disease specialists and timely initiation of eravacycline therapy following the index culture are crucial factors in enhancing clinical outcomes.
耐碳青霉烯类鲍曼不动杆菌（CRAB）的发病率不断上升，给重症监护病房（ICU）带来了挑战。依拉环素是全球推出的首个氟环素类抗生素，越来越多地用于治疗与CRAB相关的感染。本研究比较了依拉环素与替加环素治疗ICU患者CRAB肺炎的效果。
这项回顾性研究分析了2023年9月至2024年3月在河南省人民医院接受治疗的65例ICU CRAB肺炎患者；比较了以依拉环素和替加环素作为靶向治疗的临床疗效和不良反应。
两个CRAB肺炎队列的合并感染率均超过50%，主要为……和……。依拉环素组的多器官功能障碍综合征（MODS）发生率显著更高（45.5%对15.5%，P<0.05）。在使用靶向药物之前，依拉环素组患者的抗生素治疗时间更长（19.79±9.97天对14.25±7.98天；P<0.05）。同样，依拉环素组的中位住院时间长于替加环素组[27（19.50，39.00）天]对[19（14.00，29.00）天]。在进行索引培养后，依拉环素组开始使用抗生素的中位时间长于替加环素组（6.52±5.03天对4.09±3.14天；P<0.05）。依拉环素组的30天死亡率低于替加环素组（15.2%对25.0%）。值得注意的是，在接受传染病专科会诊的依拉环素治疗患者中没有死亡病例。两组之间感染症状的缓解率和治愈率没有显著差异。
在治疗CRAB肺炎方面，依拉环素显示出与替加环素相当的疗效，且安全性良好。及时咨询传染病专科医生并在索引培养后及时开始依拉环素治疗是改善临床结局至关重要的因素。
