浏览全部资源
扫码关注微信
1.贵州医科大学附属医院药学部,贵阳 550004
2.贵州医科大学附属医院药物临床试验机构,贵阳 550004
主管药师,硕士研究生。研究方向:临床药学。 E-mail:1107504278@qq.com
主任药师,硕士生导师,硕士。研究方向:临床药学。E-mail:xlm3@yeah.net
纸质出版日期:2024-07-30,
收稿日期:2024-01-24,
修回日期:2024-06-22,
扫 描 看 全 文
杨义,李明,李娜等.哌拉西林/他唑巴坦治疗成人复杂性尿路感染的真实世界研究 Δ[J].中国药房,2024,35(14):1753-1758.
YANG Yi,LI Ming,LI Na,et al.Real-world study on piperacillin-tazobactam in the treatment of complicated urinary tract infection in adults[J].ZHONGGUO YAOFANG,2024,35(14):1753-1758.
杨义,李明,李娜等.哌拉西林/他唑巴坦治疗成人复杂性尿路感染的真实世界研究 Δ[J].中国药房,2024,35(14):1753-1758. DOI: 10.6039/j.issn.1001-0408.2024.14.14.
YANG Yi,LI Ming,LI Na,et al.Real-world study on piperacillin-tazobactam in the treatment of complicated urinary tract infection in adults[J].ZHONGGUO YAOFANG,2024,35(14):1753-1758. DOI: 10.6039/j.issn.1001-0408.2024.14.14.
目的
2
探讨哌拉西林/他唑巴坦治疗成人复杂性尿路感染(cUTI)的有效性和安全性。
方法
2
回顾性分析2021年1月1日至2023年12月31日我院成人cUTI患者资料352例,所有患者均使用哌拉西林/他唑巴坦。观察患者的病原菌检出情况,治疗后的临床有效率、微生物清除率、不良反应发生情况及治疗费用。
结果
2
352例患者中,有54例患者有病原菌培养结果,以产超广谱
β
-内酰胺酶大肠埃希菌为主(48.1%)。所有患者的临床有效率为94.3%,微生物清除率为81.5%,不良反应发生率为1.4%。临床有效患者中的男性比例、泌尿外科治疗患者比例均显著高于临床无效患者,而移植科治疗患者比例、合并移植肾患者比例均显著低于临床无效患者(
P
<0.05)。根据病原菌对哌拉西林/他唑巴坦的敏感性分为目标治疗组和经验性治疗组的分析结果显示,两组患者的临床有效率比较,差异无统计学意义(
P
=0.902 5)。
结论
2
哌拉西林/他唑巴坦治疗成人cUTI的疗效显著,安全性较好。
OBJECTIVE
2
To investigate the efficacy and safety of piperacillin-tazobactam in the treatment of complicated urinary tract infection (cUTI) in adults.
METHODS
2
Retrospective analysis was performed on the data of 352 cUTI adult patients in our hospital from January 1, 2021 to December 31, 2023. All patients received piperacillin-tazobactam. The detection of pathogens in patients, the clinical efficacy and microbial clearance rate after treatment, the occurrence of adverse drug reactions and treatment cost were observed in all patients.
RESULTS
2
Of the 352 patients, pathogen culture results of 54 patients were detected, mainly
Escherichia coli
producing extended-spectrum beta-lactamases. The clinical effective rate was 94.3%, the microbial clearance rate was 81.5%, and the incidence of adverse reactions was 1.4%. The percentage of male effective patients in urinary surgery department was significantly higher than invalid patients, while the proportion of transplant treatment and the proportion of patients with concomitant kidney transplantation were significantly lower than invalid patients (
P
<0.05). There was no significant difference in clinical effective rate between the two groups after those patients were divided into target treatment group and empirical treatment group according to the sensitivity of pathogen to piperacillin-tazobactam (
P
=0.902 5).
CONCLUSIONS
2
Piperacillin-tazobactam is effective and safe in the treatment of cUTI.
哌拉西林/他唑巴坦复杂性尿路感染病原菌有效性安全性
complicated urinary tract infectionpathogenefficacysafety
尿路感染诊断与治疗中国专家共识编写组. 尿路感染诊断与治疗中国专家共识(2015版):复杂性尿路感染[J]. 中华泌尿外科杂志,2015,36(4):241-244.
China Expert Consensus Compilation Group on Diagnosis and Treatment of Urinary Tract Infections. China expert consensus on diagnosis and treatment of urinary tract infection(2015 edition):complex urinary tract infection[J]. Chin J Urol,2015,36(4):241-244.
王其琼,张舒,封宇飞,等. 新型治疗复杂性尿路感染药物:plazomicin[J]. 临床药物治疗杂志,2019,17(6):6-10.
WANG Q Q,ZHANG S,FENG Y F,et al. A new drug for the treatment of complicated urinary tract infection:plazomicin[J]. Clin Med J,2019,17(6):6-10.
覃正碧,张银高. 延长哌拉西林/他唑巴坦输注时间治疗复杂性尿路感染的临床观察[J]. 中国药房,2015,26(14):1965-1967.
QIN Z B,ZHANG Y G. Clinical observation of extending prolonged infusion time of piperacillin/tazobactam in the treatment of complicated urinary tract infections[J]. China Pharm,2015,26(14):1965-1967.
全国细菌耐药监测网. 2022年全国细菌耐药监测报告:简要版[EB/OL].(2023-11-20)[2024-04-07].https://www.carss.cn/Report/Details/917https://www.carss.cn/Report/Details/917.
China Antimicrobial Resistance Surveillance System. China antimicrobial resistance surveillance report 2022:brief version[EB/OL].(2023-11-20)[2024-04-07].https://www.carss.cn/Report/Details/917https://www.carss.cn/Report/Details/917.
全国细菌耐药监测网. 全国细菌耐药监测网2014—2019年尿标本细菌耐药监测报告[J].中国感染控制杂志,2021,20(1):53-60.
China Antimicrobial Resistance Surveillance System. Antimicrobial resistance of bacteria from urine specimens:surveillance report from China antimicrobial resistance surveillance system in 2014-2019[J]. Chin J Infect Contr,2021,20(1):53-60.
国家药品监督管理局药品审评中心. 抗菌药物临床试验技术指导原则[EB/OL].(2015-04-03)[2024-06-04].https://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODEhttps://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODE=b73cb8c787d7d0b62a11b8847419778e.
Center for Drug Evaluation,NMPA. Technical guidelines for antimicrobial clinical trials[EB/OL].(2015-04-03)[2024-06-04]. https://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODEhttps://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODE=b73cb8c787d7d0b62a11b8847419778e.
国家药品监督管理局药品审评中心.复杂性尿路感染抗菌药物临床试验技术指导原则[EB/OL].(2020-12-31)[2024-06-04]. https://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODEhttps://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODE=ab8cb7d250a2df342350cf34807009e1.
Center for Drug Evaluation,NMPA. Technical guidelines for clinical trials of antibiotics for complex urinary tract infections[EB/OL].(2020-12-31)[2024-06-04].https://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODEhttps://www.cde.org.cn/zdyz/domesticinfopage?zdyzIdCODE=ab8cb7d250a2df342350cf34807009e1.
U.S. Department of Health and Human Services,Food and Drug Administration,Center for Drug Evaluation and Research(CDER). Guidance for industry:complicated urinary tract infections:developing drugs for treatment[S].2018.
国家药品监督管理局.药品不良反应报告和监测管理办法[EB/OL].(2011-05-04)[2024-06-04].https://www.nmpa.gov.cn/yaopin/ypfgwj/ypfgbmgzh/20110504162501325.htmlhttps://www.nmpa.gov.cn/yaopin/ypfgwj/ypfgbmgzh/20110504162501325.html.
National Medical Products Administration. Measures for the administration of adverse drug reaction reporting and monitoring[EB/OL].(2011-05-04)[2024-06-04].https://www.nmpa.gov.cn/yaopin/ypfgwj/ypfgbmgzh/201105041-62501325.htmlhttps://www.nmpa.gov.cn/yaopin/ypfgwj/ypfgbmgzh/201105041-62501325.html.
GÁGYOR I,GRESER A,HEUSCHMANN P,et al. REDuction of Antibiotic RESistance(REDARES)in urinary tract infections using treatments according to national clinical guidelines:study protocol for a pragmatic randomized controlled trial with a multimodal intervention in primary care[J]. BMC Infect Dis,2021,21(1):990.
覃新芳,李清初,邹迪莎,等. 复杂性尿路感染的研究进展[J]. 内科,2018,13(3):363-366.
QIN X F,LI Q C,ZOU D S,et al. Progress in the research of complicated urinary tract infection[J]. Intern Med,2018,13(3):363-366.
李荣标,徐有学,范俊飞. 结石性肾周炎与输尿管结石的大小及尿路梗阻程度的关系[J]. 实用放射学杂志,2022,38(6):955-958.
LI R B,XU Y X,FAN J F. Correlationship of perinephritis with size of ureteral calculi and degree of urinary tract obstruction[J]. J Pract Radiol,2022,38(6):955-958.
杨仁国,王蜀强,龙姗姗,等. 复杂性尿路感染243例病原菌构成及药敏分析[J]. 中国抗生素杂志,2017,42(12):1050-1055.
YANG R G,WANG S Q,LONG S S,et al. Analysis of pathogens and drug resistances in 243 cases with complicated urinary tract infections[J]. Chin J Antibiot,2017,42(12):1050-1055.
熊琴. 尿路感染的临床表现、治疗与预后[J]. 饮食保健,2020,7(11):247.
XIONG Q. Clinical manifestations,treatment,and prognosis of urinary tract infections[J]. Diet Health,2020,7(11):247.
尹璐,杜悦. 儿童单发与再发性尿路感染病原菌分布及耐药性分析[J]. 中国医科大学学报,2023,52(9):836-842.
YIN L,DU Y. Bacterial pathogens and antibiotic resistance patterns in children with single and recurrent urinary tract infection[J]. J China Med Univ,2023,52(9):836-842.
丁锋,赵爱学. 891例中段尿培养阳性标本感染病原学特点及药敏分析[J]. 检验医学与临床,2021,18(1):112-115.
DING F,ZHAO A X. Pathogenic characteristics and drug sensitivity analysis of 891 cases of middle-stage urine culture positive samples[J]. Lab Med Clin,2021,18(1):112-115.
KAYE K S,RICE L B,DANE A L,et al. Fosfomycin for injection(ZTI-01)versus piperacillin-tazobactam for the treatment of complicated urinary tract infection including acute pyelonephritis:ZEUS,a phase 2/3 randomized trial[J]. Clin Infect Dis,2019,69(12):2045-2056.
SEO Y B,LEE J,KIM Y K,et al. Randomized controlled trial of piperacillin-tazobactam,cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum beta-lactamase-producing Escherichia coli[J]. BMC Infect Dis,2017,17(1):404.
胡梅园. 400例哌拉西林钠他唑巴坦钠致药品不良反应[J]. 中国医院用药评价与分析,2018,18(6):850-852.
HU M Y. 400 cases of adverse drug reactions induced by piperacillin sodium and tazobactam sodium[J]. Eval Anal Drug Use Hosp China,2018,18(6):850-852.
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构