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[氨曲南对血液系统疾病相关严重感染的治疗效果。阪神感染研究组]

[Therapeutic effectiveness of aztreonam on severe infections associated with hematologic disorders. Hanshin Infection Study Group].

作者信息

Hirayama F, Masaoka T, Shibata H, Nagai K, Kitani T, Horiuchi A, Kawagoe H, Yasunaga K, Okamoto Y, Yonezawa T

出版信息

Jpn J Antibiot. 1985 Sep;38(9):2402-12.

PMID:4079014
Abstract

One hundred and nine patients with infection accompanying hematologic disorders including leukemia and lymphoma were treated with aztreonam (AZT). Of the 90 patients in whom the efficacy could be evaluated, 17 (18.9%) responded markedly and 29 (32.2%) moderately, the effective rate being 51.1%. The efficacy rate classified according to infections was 25% in septicemia, 46.3% in suspected septicemia, 57.1% in pneumonia and 100% in urinary tract infection. The efficacy rate to the Gram-negative bacteria was 78.9% and to the Gram-positive bacteria was 20.0%. In 4 (66.7%) out of 6 patients in whom P. aeruginosa was the causative organism, AZT was effective. The efficacy rate was 52.2% in the 23 patients whose causative organisms were identified and 50.7% in 67 patients whose causative organisms were not identified. There was no significant difference in the efficacy rate between the patients who failed to respond to prior antibiotic therapy (53.6%) and those treated with AZT from the beginning. The initial neutrophil count did not affect the efficacy rate. Side effects which might have been caused by AZT were eruption and fever in 4 patients. Hepatic disorders and eosinophilia were observed in 7 patients. However, the relationship between AZT and these abnormal findings was not established. These results indicate that AZT is an effective and safe antibiotic for the treatment of infections accompanying hematologic disorders.

摘要

109例伴有白血病和淋巴瘤等血液系统疾病的感染患者接受了氨曲南(AZT)治疗。在90例可评估疗效的患者中,17例(18.9%)显著缓解,29例(32.2%)中度缓解,有效率为51.1%。根据感染类型分类的有效率分别为:败血症25%,疑似败血症46.3%,肺炎57.1%,尿路感染100%。对革兰氏阴性菌的有效率为78.9%,对革兰氏阳性菌的有效率为20.0%。在6例由铜绿假单胞菌作为病原体的患者中,4例(66.7%)使用AZT有效。在23例病原体已明确的患者中有效率为52.2%,在67例病原体未明确的患者中有效率为50.7%。对先前抗生素治疗无效的患者(53.6%)与一开始就接受AZT治疗的患者之间的有效率无显著差异。初始中性粒细胞计数不影响有效率。可能由AZT引起的副作用包括4例患者出现皮疹和发热。7例患者出现肝脏疾病和嗜酸性粒细胞增多。然而,未确定AZT与这些异常表现之间的关系。这些结果表明,AZT是治疗血液系统疾病伴发感染的一种有效且安全的抗生素。

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