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阿贝卡星与磷霉素联合治疗原发性肺癌患者术后耐甲氧西林金黄色葡萄球菌严重混合性肺炎

[Combination therapy with arbekacin and fosfomycin against postoperative severe mixed-pneumonia of MRSA in primary lung cancer patients].

作者信息

Harada R, Miyamoto H, Sakao Y, Hamada T, Hata E

机构信息

Department of Surgery, Mitsui Memorial Hospital, Tokyo, Japan.

出版信息

Kyobu Geka. 1995 Sep;48(10):836-40.

PMID:7474582
Abstract

We experienced successful treatment of postoperative severe pneumonia of Methicillin-resistant Staphylococcus aureus (MRSA) with combination therapy of Arbekacin (ABK) and Fosfomycin (FOM) in three lung cancer patients. Case 1 was a advanced age of seventy-nine man who had had right upper lobectomy. Case 2 was a 61-year-old man who had had left lower lobectomy and extended bilateral mediastinal lymph-node dissection through the median sternotomy. And case 3 was a 59-year-old man who had suffered from pulmonary embolism after right pneumonectomy and partial resection of left atrium and superior vena cava. All cases were immuno-compromised patients and super-infected with Gram-negative rods, and Pseudomonas aeruginosa in case 1 and case 3. Clinical symptoms were improved after the start of administration of ABK and FOM inspite of ineffectiveness of prior treatment with other antibiotics. We added staggered chemotherapy of Sulbactam/Cefoperazone (SBT/CPZ) and Ceftazidime (CAZ) for case 1 and case 3 respectively. Thus, the combination therapy of ABK and FOM might be useful for severe pneumonia of MRSA in the immunocompromised patients, and the combined staggered chemotherapy of beta-lactum agents and above would be the first choice in the treatment for the case involving Pseudomonas aeruginosa.

摘要

我们采用阿贝卡星(ABK)和磷霉素(FOM)联合治疗,成功治愈了3例肺癌患者术后耐甲氧西林金黄色葡萄球菌(MRSA)所致的严重肺炎。病例1是一位79岁的老年男性,接受了右上叶切除术。病例2是一位61岁的男性,接受了左下叶切除术,并通过正中胸骨切开术进行了双侧纵隔淋巴结扩大清扫术。病例3是一位59岁的男性,在右肺切除、左心房及上腔静脉部分切除术后发生了肺栓塞。所有病例均为免疫功能低下患者,且合并革兰氏阴性杆菌感染,病例1和病例3合并铜绿假单胞菌感染。尽管先前使用其他抗生素治疗无效,但在开始使用ABK和FOM后,临床症状有所改善。我们分别为病例1和病例3加用了舒巴坦/头孢哌酮(SBT/CPZ)和头孢他啶(CAZ)的交替化疗。因此,ABK和FOM联合治疗可能对免疫功能低下患者的MRSA严重肺炎有效,而β-内酰胺类药物与上述药物联合交替化疗将是治疗合并铜绿假单胞菌感染病例的首选。

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