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Updated: May 21, 2025

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在丹麦的一个重症监护病房中使用 piperacillin/tazobactam 和 meropenem

Hanna Jernberg¹, Marie Warrer Munch¹, Maj-Brit Nørregaard Kjær¹

¹Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet.

Danish medical journal

|March 21, 2025

概括

皮佩拉西林/塔扎巴克坦 (PTZ) 和美罗 (MER) 是丹麦ICU中常用的经验性抗生素. 结果,包括死亡率和像VRE这样的新耐药细菌,在PTZ和MER治疗组之间是相似的.

科学领域:

临界护理医学临界护理医学
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:

重症监护室 (ICU) 的患者经常患有感染,需要及时的经验性抗生素治疗.
目前指导选择广泛抗生素,如皮佩拉西林/塔扎巴克坦 (PTZ) 和美罗 (MER) 之间的证据有限.
这项研究调查了在丹麦大学医院的ICU中与PTZ和MER相关的利用和患者结果.

研究的目的:

描述在重症监护室环境中使用皮佩拉西林/塔扎巴克坦 (PTZ) 和美罗 (MER) 的实证使用情况.
为了比较PTZ和MER治疗组之间的患者结局,包括90天死亡率和获得抗生素耐药性的发展.

主要方法:

在12周内,对所有入院到24个床位的一般ICU的患者进行前性查.
纳入标准:在ICU期间接受PTZ或MER的患者.
主要结局:90天死亡率. 二次结局包括新获得的细菌耐药性的发生率.

主要成果:

在286名ICU患者中,有184人接受了PTZ和/或MER,主要作为经验性治疗.
90天死亡率相似:PTZ为28%,MER为26%,两者为29%.
9%的患者出现了新的获得性耐药性,其中最常见的是抗万素的肠球菌 (VRE) (19例中的16例).

结论:

皮佩拉西林/塔扎巴克坦 (PTZ) 和梅罗 (MER) 是丹麦大学医院ICU中广泛使用的经验性抗生素.
在PTZ和MER组之间没有观察到90天死亡率或新抗生素耐药细菌的出现的显著差异.
抗胺素抗性肠球菌 (VRE) 的发生率需要继续采取监测和感染控制措施.

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