Clinical experience with quinupristin-dalfopristin as rescue treatment of critically ill patients infected with methicillin-resistant staphylococci
Clinical experience with quinupristin-dalfopristin as rescue treatment of critically ill patients infected with methicillin-resistant staphylococci
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奎奴普汀-达福普汀抢救治疗耐甲氧西林葡萄球菌感染危重患者的临床经验
DOI：
10.1007/s00134-002-1358-7
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发表时间：
2002
影响因子：
38.9
通讯作者：
J. Peters
中科院分区：
文献类型：
--
作者：
A. Sander;Martin Beiderlinden;Schmid En;J. Peters
目的：描述奎奴普汀-达福普汀（Q-D）作为对万古霉素治疗无效的耐甲氧西林葡萄球菌引起的严重感染的危重患者的补救治疗的有效性和安全性。设计：在Q-D同情使用计划的背景下进行的观察性研究。方法：12例严重葡萄球菌感染的机械通气患者，尽管体外敏感性，但万古霉素预处理失败。患者静脉注射Q-D 7.5 mg/kg体重，每日3次。Q-D治疗持续时间平均为11.8天（范围：1-26天）。结果：耐甲氧西林金黄色葡萄球菌（MRSA）和表皮葡萄球菌（MRSE）分别在3例患者中分离出，两种细菌均在6例患者中分离出。12例患者中有7例（66%）实现了病原体根除。5例患者（42%）死于重度合并症。未观察到与Q-D相关的不良事件，肾功能和肝功能均未受到不良影响。结论：奎奴普汀-达福普汀似乎是一种有效和安全的抗菌药物，用于危重患者葡萄球菌感染的抢救治疗。在万古霉素治疗失败的情况下，可考虑将其作为一种治疗选择。
AbstractObjectives.To describe the efficacy and safety of quinupristin-dalfopristin (Q-D) as rescue therapy in critically ill patients with severe infections caused by methicillin-resistant staphylococci unresponsive to vancomycin treatment.Design.Observational study in the context of the compassionate use programme for Q-D.Methods.Twelve mechanically ventilated patients suffering from severe staphylococcal infections, pretreated unsuccessfully with vancomycin despite in vitro sensitivity, were included. Patients received, intravenously, Q-D 7.5 mg/kg body weight 3 times daily. The duration of Q-D therapy averaged 11.8 days (range: 1–26 days). The outcome variables were clinical efficacy and bacteriological eradication.Results.Methicillin-resistantStaphylococcus aureus(MRSA) andStaphylococcus epidermidis(MRSE) were isolated in three patients each, and both bacteria were isolated from six patients. Eradication of pathogen(s) was achieved in 7 of 12 patients (66%). Five patients (42%) died due to severe co-morbidity. Adverse events related to Q-D were not observed and neither renal nor liver function was adversely affected.Conclusions.Quinupristin-dalfopristin appears to be an efficient and safe antimicrobial drug for the rescue treatment of staphylococcal infections in critically ill patients. It may be considered as a treatment option in cases of vancomycin treatment failure.