Analysis efficacy of tigecycline in the treatment of multidrug-resistant bacterial infections in elderly patients with critical illness
10.13699/j.cnki.1001-6821.2017.14.001
- VernacularTitle:替加环素注射剂治疗多重耐药菌感染老年危重症患者的疗效分析
- Author:
Dan SUN
1
;
Hong-Mei JIAO
;
Zi-Qian LI
;
Ying ZHOU
;
Xue-Ying LI
;
Zhi-Fang FU
Author Information
1. 北京大学第一医院老年内科
- Keywords:
tigecycline;
elderly patients with critical illness;
multidrug-resistant bacterial infections
- From:
The Chinese Journal of Clinical Pharmacology
2017;33(14):1291-1294
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and predictive factors of tigecycline in the treatment of multi drug-resistant infections in elderly patients with critical illness.Methods Forty elderly patients with critical illness treated by tigecycline for multi drug-resistant infections were enrolled,the efficacy was evaluated and predictive factors were explored.Tigecycline was administered intravenously with initial dose of 100 mg,followed by 50-100 mg every 12 h for 4 to 19 d.Their clinical data,sites of infection,pathogens,medication prescribed,laboratory parameters,acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ),sequential organ failure assessment(SOFA),simplified acute physiology score Ⅱ (SAPS Ⅱ) before and after treatment were collected.Patients enrolled in the study were divided into an ineffective group(n =18 cases) and an effective group (n =22 cases).Receiver operating characteristic (ROC) curve was performed to evaluate the value of APACHE Ⅱ score,SOFA score and SAPS Ⅱ score in predicting the efficacy of tigecycline.Results In effective group,endogenous creatinine clearance rate (Ccr) before and after treatment were (64.44 ± 27.24),(71.78 ± 30.38) mL · min-1,procalcitonin (PCT) were 0.41(0.05,25.00),0.13(0.05,4.00)ng · mL-1,with significant difference (P ＜0.05).In ineffective group,Ccr before and after treatment were (58.34 ± 28.18),(47.58 ± 31.91) mL · min-1 (P ＜ 0.05).In ineffective group,the APACHE Ⅱ scores before and after treatment were 25.06 ± 10.18 and 30.83 ± 14.71,the SOFA scores were 9.89 ±5.32 and 12.78 ±5.75,the SAPS Ⅱ scores were 60.39 ±20.18 and 72.33 ±22.72,respectively,showing significant statistical differences (P ＜ 0.05).There were significant statistical differences (P ＜ 0.05) among AUC of APACHE Ⅱ score,SOFA score and SAPS Ⅱ score in ROC analysis,which were 0.73,0.74 and 0.78 respectively.Conclusion APACHE Ⅱ score,SOFA score and SAPS Ⅱ score have a significant predictive value for the efficacy of tigecycline treatment of multiple drug-resistant infections in elderly critically ill patients.
