论文部分内容阅读
目的:评价利奈唑胺治疗严重G~+菌感染的疗效与安全性。方法:计算机检索MEDLINE,CHKI与万方数据库中有关利奈唑胺临床疗效与安全性的随机对照试验(RCT)及综述,检索时间均从2000～2009年,并对检索文献予以综述。结果:RCT疗效评价包括G~+菌所致菌血症,社区获得性肺炎,医院获得性肺炎,复杂性皮肤与软组织感染及耐万古霉素屎肠球菌感染等临床研究。在安全性方面,利奈唑胺最常见的严重不良反应有:贫血、白细胞减少与血小板减少症;乳酸酸中毒、周围与视神经病变,惊厥及5羟色胺综合征。这些严重不良反应或不良事件发生,既可在延长利奈唑胺用药时间(治疗时间大于2周),也可在与其他药物联用或同时食用某些食物时发生。结论:利奈唑胺对于治疗G~+菌感染是重要、有效与相对安全的选择;利奈唑胺对耐药G~+菌如MRSA,耐万古霉素屎肠球菌等所致感染均具有良好疗效。有指征地使用利奈唑胺将有利于减少细菌对利奈唑胺耐药性的产生。
Objective: To evaluate the efficacy and safety of linezolid in the treatment of severe G ~ + infection. Methods: Randomized controlled trials (RCTs) and reviews on clinical efficacy and safety of linezolid in MEDLINE, CHKI and Wanfang database were searched by computer. The retrieval time was from 2000 to 2009, and the search literature was reviewed. Results: The clinical evaluation of RCT included bacteremia caused by G ~ + bacteria, community-acquired pneumonia, hospital-acquired pneumonia, complex skin and soft tissue infections and vancomycin-resistant Enterococcus faecium infection. In terms of safety, the most common serious adverse reactions of linezolid are: anemia, leukopenia and thrombocytopenia; lactic acidosis, peripheral and optic neuropathy, convulsions and serotonin syndrome. These serious side effects or adverse events can occur either with prolonged linezolid administration (for more than 2 weeks) or with certain other drugs or with certain foods. Conclusion: Linezolid is an important, effective and relatively safe choice for the treatment of G ~ + infection. Linezolid has good curative effect on drug resistant G ~ + strains such as MRSA, vancomycin - resistant Enterococcus faecium . The indicated use of linezolid will be beneficial in reducing bacterial resistance to linezolid.