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題 名 | Doripenem用於老年泌尿道感染療效=Efficacy of Doripenem in the Elderly with Urinary Tract Infections |
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作 者 | 黃美嫆; 汪忠炫; | 書刊名 | 藥學雜誌 |
卷 期 | 29:4=117 2013.12[民102.12] |
頁 次 | 頁62-68 |
分類號 | 418.281 |
關鍵詞 | 老人; 泌尿道感染; 抗生素; Urinary tract infections; Doripenem; Levofloxacin; Gram(-) bacilli; Escherichia coli; Pseudomonas aeruginosa; |
語 文 | 中文(Chinese) |
中文摘要 | 泌尿道感染為老人最常見的感染之一,感染的致病菌以大腸桿菌最常見。抗藥性日益增多,醫院常見難治療的 Gram(-)菌,困擾著醫師對抗生素的選擇。因此,這篇文章的目的是針對院內使用 carbapenam類的新藥 -doripenem於加護病房治療感染症的療效及安全性評估,並且比較兩種抗生素 (doripenem vs. levofloxacin)在老年人泌尿道感染的療效,以提供醫師對抗生素藥品選擇。以回溯性研究方法收集 2010年10月至 2011年12月加護病房 65歲以上老年人使用 doripenem治療感染症,剔除藥療小於 3天內病人後共得 170位。為探討比較 doripenem和 levofloxacin治療老年人泌尿道感染的療效,收集從 2010年10月至 2011年12月間診斷碼為泌尿道感染的 65歲以上病人,共得 55位用 doripenem與128位用 levofloxacin治療泌尿道感染的病人。將收集資料以 SPSS 17.0軟體進行統計分。結果經 doripenem治療後,有 121位病人轉一般病房,存活率 71.2% (121/170)。經 doripenem療程結束後病人的 white blood cell (WBC)與 C-reactive protein (CRP)都有改善,並具統計上意義。比較 doripenem (n=55)與 levofloxacin (n=128)在泌尿道感染療效,存活率分別為 85.5%與97.6%。兩組尿液分離出前二名菌種為 Escherichia coli及 Escherichia coli (ESBL)。研究顯示重症病房感染症,以 doripenem治療所有感染相對泌尿道感染治癒率分別為 71.2%與85.5%。老年病人發生感染,臨床上懷疑是 Gram(-)菌引起困難治療的感染時,新藥 doripenem提供另一抗生素藥品選項。 |
英文摘要 | Urinary tract infection is one of the most common infections in the elderly, for which the most common pathogen is Escherichia coli. As antibiotic resistance getting increasing, it becomes progressively more difficult to treat these common Gram (-) bacteria, hindering physicians from effectively choosing antibiotics to treat them. The aim of this study is to investigate the safety and efficacy of using a new carbapenem – doripenem – to treat refractory infections in the Intensive Care Unit (ICU) retrospectively, and to facilitate the doctors' decision making process by comparing the success rates between doripenem and levofloxacin for treating urinary tract infections (UTI) in the elderly. Totally 170 patients over the age of 65 who infections which were treated with doripenem in the ICU for over three days from October 2010 to December 2011 were reviewed. In order to compare the effectiveness of doripenem and levofloxacin for treatment of UTI in the elderly, during the same period of time, 55 elderly patients treated with doripenem and 128 elderly patients treated with levofloxacin were included for evaluation. SPSS 17.0 was used for statistical analysis. Result: among the 170 ICU cases of infections treated with doripenem, 121 patients became stable, and were transferred to general wards, resulting in a survival rate of 71.2%. After treatment with doripenem, both the patients' white blood cell count (WBC) and C reactive protein (CRP) show improved with statistical significance. In cases of diagnostic UTI, the survival rates in doripenem group (n=55) was 85.5%, while in levofloxacin group (n=128) was 97.6%. The most prevalent microorganisms isolated from UTI patients in this study were Escherichia coli and Escherichia coli (ESBL). In summary, our studies have shown that for all infections vs. UTI treated with doripenem survival rates are 71.2% and 85.5%, respectively. Clinically, if a refractory infection in the elderly is suspected to be caused by Gram (-) bacteria, the new drug doripenem might be an alternative choice of antibiotic. |
本系統中英文摘要資訊取自各篇刊載內容。