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目的 观察哌拉西林 /三唑巴坦 (他唑西林 )对照头孢哌酮 /舒巴坦 (舒普深 )治疗老年人免疫损害宿主( ICH)合并院内获得性肺炎的疗效。方法 56例 ICH合并院内获得性肺炎分为哌拉西林 /三唑巴坦治疗组及头孢哌酮 /舒巴坦对照组 ;治疗组 3 0例 ;应用哌拉西林 /三唑巴坦每日 10 .0～ 18.0分 2～ 3次静点 ,疗程 10～ 14 d;对照组 2 6例 ,分 2次静点 ,疗程 10～ 14 d。结果 哌拉西林 /三唑巴坦治疗总有效率 83 .3 % ,细菌清除率 80 .8% ;头孢哌酮 /舒巴坦组治疗总有效率 80 .8% ,细菌清除率 81.0 % ,两组治疗总有效率及细菌清除率差异均无显著性( P>0 .0 5)。结论 哌拉西林 /三唑巴坦是治疗老年 ICH合并院内获得性肺炎的良效药物 ,安全、低毒、高效、抗菌谱广 ,患者耐受性好 ,对铜绿假单胞菌清除率高 ;治疗剂量一般要大 ,疗程要足 ,但仍需密切观察肝肾功能。
Objective To observe the efficacy of piperacillin / tazobactam (cefoxitin) versus cefoperazone / sulbactam (shuopu shen) in the treatment of elderly immunocompromised host (ICH) with nosocomial pneumonia. Methods Fifty-six ICH complicated with nosocomial pneumonia were divided into piperacillin / tazobactam group and cefoperazone / sulbactam control group. The treatment group was 30 cases. Piperacillin / tazobactam 10 .0 ~ 18.0 points 2 ~ 3 times the static point, the course of treatment 10 ~ 14 d; control group 26 cases, 2 points, treatment 10 ~ 14 d. Results The total effective rate of piperacillin / tazobactam was 83.3% and the bacterial clearance rate was 80.8%. The total effective rate of cefoperazone / sulbactam group was 80.8% and the bacterial clearance rate was 81.0% There was no significant difference in the total effective rate and bacterial clearance between the two groups (P> 0.05). Conclusion Piperacillin / tazobactam is a good drug for the treatment of ICH with nosocomial pneumonia in elderly patients. It is safe, low toxicity, high efficiency, broad antimicrobial spectrum, patient tolerance is good and the clearance rate of Pseudomonas aeruginosa is high. The treatment dose is generally large, course of treatment to be sufficient, but still need close observation of liver and kidney function.