塞法胺-阿维巴克坦与或没有阿兹特雷奥纳姆与基于聚米辛的组合疗法对抗卡巴尼姆的肠杆菌:回顾性分析
Parikshit S Prayag1, Sampada A Patwardhan2, Shweta Panchakshari1
1Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, India.
概括
塞法胺-阿维巴克坦 (CAZ-AVI) 治疗显示,对抗卡巴胺耐药肠杆菌菌 (CRE) 感染的治疗结果比基于多素的治疗更好. CAZ-AVI与较低的死亡率和较少的毒性有关,这表明它可能是一个优越的治疗选择.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 格拉姆阴性败血症是ICU的一个重大挑战,耐卡巴耐药的肠道细菌 (CRE) 构成了主要威胁.
- 由于对多种类型的抗微生物药物 (包括卡巴烯) 的耐药性,CRE感染很难治疗.
- 有限的比较数据存在于基于polymyxin与基于ceftazidime-avibactam (CAZ-AVI) 的治疗对CRE.
研究的目的:
- 为了比较基于polymyxin的组合治疗与基于CAZ-AVI的治疗在CRE细菌病患者的临床结果.
- 评估两种治疗方案之间的死亡率和毒性差异.
主要方法:
- 一项回顾性研究分析了104名患有CRE细菌病的患者.
- 患者接受了基于聚米辛的组合疗法或基于CAZ-AVI的治疗 (有或没有阿兹特雷诺姆).
- 结果,包括14日和28日的死亡率和毒性,在两组之间进行了比较.
主要成果:
- 在CAZ-AVI组包括78名患者 (75%).
- 两组之间并发症没有显著差异.
- 毒性发生率在多素组显著更高 (p=0.017).
- CAZ-AVI治疗与14日 (p=0.048) 和28日 (p=0.039) 死亡率显著降低有关.
结论:
- 与基于聚胺的治疗相比,基于Ceftazidime-avibactam的治疗似乎是治疗CRE感染的优越选择.
- 这一发现对优化患者治疗和保护多素使用具有实际意义.
- 进一步的研究可能会支持CAZ-AVI作为管理CRE感染的首选药物.
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