在医院获得的肺炎中Polyymyxin B Plus气溶性胆固醇与单独的Polyymyxin B ("AEROCOL"研究):一个可行性研究
1Department of Critical Care Medicine, Fortis Escorts Hospital, Faridabad, Haryana, India.
概括
在静脉注射聚米辛-B中添加气溶胆固醇素并没有显著改善由广泛耐药的グラム阴性病原体引起的医院获得性肺炎 (HAP) 的治疗成功. 微生物学治愈率在气溶胆固醇组中更高.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 由广泛耐药性 (XDR) 格拉姆阴性病原体引起的医院获得性肺炎 (HAP) 构成了重大的治疗挑战.
- 聚米辛-B是治疗这种感染的关键抗生素,但其有效性可能有限.
研究的目的:
- 为了评估高剂量气溶性胆固醇与静脉注射的聚米辛-B相结合的高剂量气溶性胆固醇与静脉注射的聚米辛-B单独的疗效,用于治疗侵袭性通风成人ICU患者的HAP.
- 评估与联合治疗策略相关的临床结果,微生物学治愈和不良事件.
主要方法:
- 进行了一项随机对照试验,对成年ICU患者进行了随机对照试验,这些患者被诊断为由于XDR阴性病原体引起的HAP.
- 患者接受了静脉注射的聚米辛-B加高剂量气溶性胆固醇素 (每8小时5百万单位) 或单独静脉注射的聚米辛-B.
- 该研究是一项可行性研究,由于招聘速度缓慢,该研究提前关闭.
主要成果:
- 在组合组中,治疗成功率不显著地更高 (63.66%与30.77%,p=0.217).
- 在组合组中,微生物学治愈率明显高 (60%对9.09%,p=0.018).
- 二级结局,包括无发烧日和死亡率,显示了数值的改善,但没有达到统计学意义. 在气溶注射期间发生了两次过渡性缺氧.
结论:
- 这项研究无法证明高剂量喷雾化胆固醇素加全身聚米辛-B与单独的聚米辛-B相比,在治疗由XDR细菌阴性病原体引起的HAP方面具有优越性.
- 虽然微生物疗法得到了改善,但整体临床益处没有达到统计学意义,研究的可行性因招募速度缓慢而受到限制.
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