Comparison of efficacy of high dose tigecycline and polymyxin B in the treatment of pulmonary infection due to carbapenem-resistant organism
10.12138/j.issn.1671-9638.20256651
- VernacularTitle:高剂量替加环素与多黏菌素B治疗肺部耐碳青霉烯类革兰阴性杆菌感染的疗效比较
- Author:
Buyao ZHANG
1
;
Qinlan HOU
;
Minhui YIN
;
Pengyu WANG
;
Chenghuan HU
;
Xun HUANG
;
Shuangping ZHAO
Author Information
1. 中南大学湘雅医院重症医学科,湖南长沙 410008
- Publication Type:Journal Article
- Keywords:
tigecycline;
polymyxin B;
carbapenem-resistant organism;
clinical efficacy;
CRO
- From:
Chinese Journal of Infection Control
2025;24(1):15-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy of high-dose tigecycline(TGC)and polymyxin B(PMB)in the treatment of pulmonary infection due to carbapenem-resistant organism(CRO).Methods Clinical data of pa-tients with CRO pulmonary infection and received PMB or high-dose TGC combined with other antimicrobial treat-ment regimens in Department of Critical Care Medicine of Xiangya Hospital,Central South University from January 2019 to March 2022 were analyzed retrospectively,including basic information,pathogen detection results,antimi-crobial use regimen,clinical efficacy,30-day mortality,bacterial clearance rate,etc.Results A total of 173 pa-tients were included in analysis,with 103 in the TGC group and 70 in the PMB group.Compared with TGC group,PMB group had a higher score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)(25.0 vs 20.0,P＜0.001),but clinical efficacy rates were not statistically different(67.1％vs 52.4％,P=0.054).Stratified analysis revealed that when the APACHE Ⅱ score was ≥15 points,compared with TGC group(n=78),PMB group(n=66)had a higher APACHE Ⅱ score(27.0 vs 22.0,P=0.005)and a higher clinical efficacy rate(66.7％vs 47.4％,P=0.020).After adjusting confounding factors through logistic regression analysis,it was found that PMB treatment was a protective factor for clinical efficacy rate compared with TGC treatment.Conclusion For treating pulmonary infection caused by CRO in patients,PMB-based treatment regimen has a significant protec-tive effect on the clinical efficacy rate compared with the high-dose TGC-based treatment regimen.
