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題名 | 對抗HA-MRSA肺炎的新抗生素=The Novel Antibiotic Aganist HA-MRSA Pneumonia |
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作者姓名(中文) | 康建文; | 書刊名 | 藥學雜誌 |
卷期 | 30:4=121 2014.12[民103.12] |
頁次 | 頁60-65 |
分類號 | 415.463、415.463 |
關鍵詞 | 院內感染肺炎; Methicilin-resistant staphylococcus aureus; Hospital acquired pneumonia; Lipoglycopeptides; |
語文 | 中文(Chinese) |
中文摘要 | 抗甲氧苯青黴素金黃色葡萄球菌 (methicilin-resistant Staphylococcus aureus, MRSA) 是院內感染 (hospital acguired;HA) 肺炎最常見之菌種之一,但首選以 vancomycin 為主的糖肽類抗生素 (glycopeptides) 治療 MRSA 的高失敗率,常導致臨 床治療的困難;因此,新一類抗生素 telavancin 核准對抗 HA-MRSA 肺炎的成效令 人期待。根據臨床試驗結果,當 vancomycin MICs ≥ 1 μg/mL 時,成效有明顯差異 87.1% (telavancin) vs. 74.3% (vancomycin);95% CI,0.5-23,p = 0.03,不過血清肌 酐酸 (serum creatinine) 增加幅度大於50%或超過1.5 mg/dL 的比例高於 vancomycin (telavancin 16% vs. vancomycin 10%),但影響是可逆的,需密切監測腎功能的變化, 尤其是腎功能不全 (CrCl ≤ 50 mL/min)。Telavancin 治療 HA-MRSA 肺炎整體效益並不 亞於 vancomycin,但統計學上的差別並不明顯,未來仍需更進一步的隨機對照組試驗 (randomized controlled trial, RCT) 以釐清其治療 HA-MRSA 肺炎的臨床效益。 |
英文摘要 | Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA), is the most common pathogens of hospital-acquired pneumonia (HAP). But the rates of clinical failure in patients with HAP due to MRSA are high, especially in vancomycin. Therefore, the novel antibiotic of lipoglycopeptide - telavancin is exciting for treatment of HAP. According to results of clinical trials, when vancomycin MICs ≥ 1 μg/mL, telavancin was significantly inferior to vancomycin (87.1% vs 74.3%;95% CI ,0.5-23, p = 0.03) and also found the increases of serum creatinine levels were more common in the telavancin group (16% vs 10%). Hence, when using telavancin should be closely monitored, especially in renal insufficiency (CrCl ≤ 50 mL/min). In conclusion, telavancin is noninferior to vancomycin in the treatment of HAP, but no significant differences. We still need the further randomized controlled trials to clarify the benefit. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。