利奈唑胺对MRSA肺炎肥胖患者的疗效优于万古霉素

2012-09-28 网络 网络

    抗微生物制剂和化疗跨学科会议上公布的一项美国全国回顾性队列分析显示,利奈唑胺对耐甲氧西林金黄色葡萄球菌(MRSA)肺炎肥胖患者的疗效优于万古霉素。     在该研究中,49例体重指数(BMI)≥30 kg/m2的患者通过静脉或口服方式接受600 mg(标准剂量)利奈唑胺治疗,每12 h给药1次。740例患者接受标准剂量万古霉素治

    抗微生物制剂和化疗跨学科会议上公布的一项美国全国回顾性队列分析显示,利奈唑胺对耐甲氧西林金黄色葡萄球菌(MRSA)肺炎肥胖患者的疗效优于万古霉素。

    在该研究中,49例体重指数(BMI)≥30 kg/m2的患者通过静脉或口服方式接受600 mg(标准剂量)利奈唑胺治疗,每12 h给药1次。740例患者接受标准剂量万古霉素治疗。患者接受至少3天治疗。临床成功定义为第14天前在无死亡、治疗变更或插管情况下从ICU或普通病房出院。结果显示,利奈唑胺用药者的临床成功率高于万古霉素用药者(HR,1.77;95%CI,1.18~2.64)。

    研究者表示不清楚产生这一结果的确切原因,有可能是因为万古霉素的剂量部分按体重计算,或是因为对肥胖患者给予的万古霉素剂量存在问题。即使BMI提示用药剂量需超过标准剂量,但临床医生出于对毒性的担心,通常不愿意这么做。尚不清楚该研究中的患者接受的万古霉素剂量是否充足。利奈唑胺在给药剂量上则较为简单直接,因此肥胖患者可能更易于接受正确的剂量。

    除了上述结果之外,研究者还发现,接受利奈唑胺治疗的非肥胖患者的30天再住院率较低(HR,0.60;95%,CI 0.37~0.97)。在其他预后方面,两种药物之间无差异。

   

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    2014-12-30 生物谷客户端朋友

    金黄色

    0

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    2014-12-30 生物谷客户端朋友

    Medsci is so good

    0

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