Comparison of imipenem and ceftazidime as therapy for severe melioidosis
Comparison of imipenem and ceftazidime as therapy for severe melioidosis
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DOI：
10.1086/520219
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发表时间：
1999-08-01
影响因子：
11.8
通讯作者：
White, NJ
中科院分区：
文献类型：
--
作者：
Simpson, AJH;Suputtamongkol, Y;White, NJ
本研究采用开放、前瞻性、随机、对照的方法，比较大剂量静脉注射亚胺培南与头孢他啶治疗急性重症类鼻疽的疗效。疑似急性、重度类鼻疽的泰国成年患者随机接受亚胺培南（剂量为50 mg/（kg.d））或头孢他啶（剂量为120 mg/（kg.d））治疗至少10天。主要结局指标为死亡或治疗失败。在入组的296例患者中，214例经培养证实为类鼻疽，其中132例（61.7%）血培养阳性。类鼻疽患者的死亡率总体为36.9%。总体生存率（P = 0.96）和48小时后生存率（P = 0.3）无差异，48小时后治疗失败在头孢他啶治疗的患者中更常见（P = 0.011），两种治疗均耐受良好。亚胺培南是治疗急性重症类鼻疽安全有效的药物，可考虑替代头孢他啶。
An open, prospective, randomized, comparative treatment trial was conducted to compare the therapeutic efficacy of high-dose intravenous imipenem and ceftazidime for acute severe melioidosis. Adult Thai patients with suspected acute, severe melioidosis were randomized to receive either imipenem, at a dosage of 50 mg/(kg.d), or ceftazidime, at a dosage of 120 mg/(kg.d), for a minimum of 10 days. The main outcome measures were death or treatment failure. Of the 296 patients enrolled, 214 had culture-confirmed melioidosis, and 132 (61.7%) of them had positive blood cultures. Mortality among patients with melioidosis was 36.9% overall. There were no differences in survival overall (P = .96) or after 48 hours (P = .3), Treatment failure after 48 hours was more common among patients treated with ceftazidime (P = .011), Both treatments were well tolerated. Imipenem is a safe and effective treatment for acute severe melioidosis and may be considered an alternative to ceftazidime.