Efficacy and safety analysis of tigecycline and polymyxin B in the treatment of carbapenem-resistant enterobacteriaceae pneumonia in critically ill patients
AIM:To compare the efficacy and safe-ty of tigecycline with polymyxin B in the treatment of carbapenem resistant enterobacteriaceae(CRE)pneumonia in critically ill patients.METHODS:A retrospective analysis was performed on the clinical data of patients with CRE pneumonia who received tigecycline or polymyxin B therapy from January 1,2018 to Jun 30,2023 in the Intensive Care Unit(ICU).Primary outcomes included the 28-day all-cause mortality and clinical cure rate within 28days.Secondary outcomes included the ICU mortality,in-hospital mortality,the length of hospital stay and ICU stay,microbial eradication,duration of mechan-ical ventilation.Independent predictors affecting 28-day clinical cure rate were tested using Cox re-gression analyses.RESULTS:A total of 83 eligible patients were included in the final analysis after propensity score matching,54 in the tigecycline group and 29 in the polymyxin B group.The 28-day all-cause mortality was 31.5％(17/54)in the tigecy-cline group and 37.9％(11/29)in the polymyxin B group,the difference was not statistically signifi-cant(P=0.554);the clinical cure rate was 63％(34/54)in the tigecycline group,which was significantly higher than that of the polymyxin B group of 34.5％(10/29)(P=0.013).There were no statistical differ-ences between the two groups in terms of second-ary outcomes.Multivariate logistic regression analy-sis found that the use of tigecycline was an inde-pendent predictor of the 28-day clinical cure rate(HR 2.083,95％CI 1.018-4.263,P=0.045).However,activated partial thromboplastin time(APTT)and prothrombin time(PT)were significantly prolonged in the tigecycline group compared with the poly-myxin B group(P=0.047;P=0.027),and fibrinogen(FIB)was significantly decreased(P＜0.001)after drug administration.CONCLUSION:There was no significant difference in 28-day all-cause mortality between the tigecycline and polymyxin groups;tige-cycline might be associated with a higher 28-day clinical cure rate compared with polymyxin B.It should be noted that tigecycline may increase the risk of coagulation abnormalities.
万方数据
维普
