替加环素治疗感染性疾病临床疗效及影响因素
Clinical efficacy and influencing factors of tigecycline in treatment of infectious diseases
冯绪强 1高萍 2孙超 3陶琳 4闫根全 2冷冰2
作者信息
- 1. 山东第一医科大学附属省立医院药学部,山东 济南 250021;济南市第二妇幼保健院药剂科,山东 济南 271100
- 2. 山东第一医科大学附属省立医院药学部,山东 济南 250021
- 3. 山东大学第二医院临床药学科,山东 济南 250033
- 4. 济南市第二妇幼保健院药剂科,山东 济南 271100
- 折叠
摘要
目的 探讨替加环素治疗感染性疾病的临床疗效和影响因素.方法 回顾性收集山东第一医科大学附属省立医院 2017 年 1 月至 2020 年 12 月应用替加环素住院患者的病历 746 份,分析临床资料特征,评价临床疗效及影响因素.结果 本研究纳入有效病例 726 例,感染以呼吸系统感染(65.43%)和复杂性腹腔内感染(complicated intra-abdominal infection,cIAI)(27.13%)为主.临床有效率约为 65.70%,不良反应发生率约为 4.68%.Logistic回归分析显示应用替加环素治疗无效的危险因素为恶性实体肿瘤(OR=1.931,95%CI:1.161～3.214,P=0.011)、呼吸系统感染(OR=1.704,95%CI:1.096～2.649,P=0.018)、感染性休克(OR=2.784,95%CI:1.766～4.389,P<0.001)、呼吸机辅助通气(OR=1.809,95%CI:1.143～2.862,P=0.011)和应用连续肾脏替代治疗(continuous renal replacement therapy,CRRT)(OR=1.886,95%CI:1.136～3.129,P=0.014);而入住 ICU(OR=0.518,95%CI:0.309～0.870,P=0.013)、长用药疗程(OR=0.952,95%CI:0.919～0.985,P=0.005)是治疗的保护因素.结论 替加环素适用于病情危重、多重耐药菌所致的复杂难治性感染,患者合并恶性实体肿瘤、呼吸系统感染、感染性休克、呼吸机辅助通气和CRRT时治疗无效危险性更高,需慎重使用并加强治疗监护.
Abstract
Objective To investigate the clinical efficacy and influencing factors of tigecycline in the treatment of infec-tious diseases.Methods A total of 746 medical records of patients treated with tigecycline in Shandong Provincial Hos-pital Affiliated to Shandong First Medical University during January 2017 and December 2020 were retrospectively col-lected,and the clinical data of patients were analyzed to evaluate the clinical efficacy and factors.Results This study included 726 valid cases.Respiratory infection(65.43%)and complicated intra-abdominal infection(cIAI)(27.13%)were the main infections.The clinical effective rate was 65.70%,and the incidence of adverse reactions was 4.68%.Logistic regression analysis showed that the risk factors for the failure of tigecycline treatment were malignant solid tumor(OR=1.931,95%CI:1.161-3.214,P=0.011),respiratory system infection(OR=1.704,95%CI:1.096-2.649,P=0.018),septic shock(OR=2.784,95%CI:1.766-4.389,P<0.001),mechanical ventilation(OR=1.809,95%CI:1.143-2.862,P=0.011)and continuous renal replacement therapy(CRRT)(OR=1.886,95%CI:1.136-3.129,P=0.014),while the protective factors were admission to ICU(OR=0.518,95%CI:0.309-0.870,P=0.013)and long duration(OR=0.952,95%CI:0.919-0.985,P=0.005).Conclusion Tigecycline is mainly used for the treat-ment of severe and complex infections caused by multidrug-resistant bacteria.Patients with malignant solid tumor,respiratory system infection,septic shock,mechanical ventilation and CRRT have higher risk of tigecycline treatment failure,which should be paid attention to during the treatment.
关键词
细菌感染/替加环素/临床疗效/影响因素Key words
Bacterial infection/Tigecycline/Clinical efficacy/Influencing factors引用本文复制引用
出版年
2024
NETL
NSTL
万方数据