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中国误诊学杂志 2011年第28期11卷 6886-6887页

作者：李晓鲁戴红艳尤淑玲徐桂香李伟张洪磊叶欣曹继花李玲苏璟山东大学附属千佛山医院山东省千佛山医院急救中心山东济南250014 青岛市市立医院

目的观察优化头孢他啶治疗方案对心力衰竭合并下呼吸道感染的临床疗效。方法 63例以头孢他啶每12h 1g静脉输注为对照组。实验组62例患者给予头孢他啶1g快速输注,后2g于3h内给予;共7d。结果实验组和对照组的有效率分别为95.2%及93.6%(P&g... 详细信息

目的观察优化头孢他啶治疗方案对心力衰竭合并下呼吸道感染的临床疗效。方法 63例以头孢他啶每12h 1g静脉输注为对照组。实验组62例患者给予头孢他啶1g快速输注,后2g于3h内给予;共7d。结果实验组和对照组的有效率分别为95.2%及93.6%(P>0.05);实验组细菌清除率(58.3%)稍高于对照组(53.1%,P>0.05);对照组复诊次数明显减少。结论头孢他啶根据药效/药代学理论优化的治疗方案疗效好,值得推广。

关键词：心力衰竭,充血性/并发症/药物疗法呼吸道感染/并发症/药物疗法头孢他啶/治疗应用

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头孢他啶加龙血竭治疗压疮效果观察

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中国误诊学杂志 2010年第33期10卷 8118-8118页

作者：蔡雪玲河北滦南县医院 063500

目的观察头孢他啶+龙血竭胶囊粉治疗压疮的临床疗效。方法选择滦南县医院骨科64例入院时带入Ⅰ、Ⅱ期压疮的患者,随机分实验组和对照组,实验组采用清创、消毒、头孢他啶+龙血竭胶囊粉用香油调和涂创面,对照组常规外科无菌换药处理创面... 详细信息

目的观察头孢他啶+龙血竭胶囊粉治疗压疮的临床疗效。方法选择滦南县医院骨科64例入院时带入Ⅰ、Ⅱ期压疮的患者,随机分实验组和对照组,实验组采用清创、消毒、头孢他啶+龙血竭胶囊粉用香油调和涂创面,对照组常规外科无菌换药处理创面。结果实验组采用头孢他啶+龙血竭胶囊粉涂创面治疗压疮总有效率96.8%,对照组治疗总有效率62.5%,两者比较差异有统计学意义(P<0.05)。结论头孢他啶+龙血竭胶囊粉涂创面治疗Ⅰ、Ⅱ期压疮安全、有效。

关键词：头孢他啶/治疗应用血竭/治疗应用褥疮/药物疗法人类

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头孢他啶联合双黄连治疗COPD合并下呼吸道感染的临床观察

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中国误诊学杂志 2007年第27期7卷 6511-6512页

作者：于龙刚于梅菊山东省潍坊市人民医院药剂科 261041 潍坊市奎文区妇保院 261041

目的:研究头孢他啶联合双黄连治疗慢性阻塞性肺疾病(COPD)合并下呼吸道感染的疗效。方法:采用前瞻性、随机平行对照的研究方法,选择2005-01～2006-09诊断的108例COPD患者合并下呼吸道感染病例.随机分成A组54例(给予头孢他啶2g静脉滴注,2... 详细信息

目的:研究头孢他啶联合双黄连治疗慢性阻塞性肺疾病(COPD)合并下呼吸道感染的疗效。方法:采用前瞻性、随机平行对照的研究方法,选择2005-01～2006-09诊断的108例COPD患者合并下呼吸道感染病例.随机分成A组54例(给予头孢他啶2g静脉滴注,2次/d)、B组54例(给予头孢他啶2g静脉滴注,2次/d,双黄连20ml静脉滴注,1次/d),观察两组疗效。结果:头孢他啶联合双黄连组治疗COPD合并下呼吸道感染体温恢复正常的时间、肺部湿罗音消失时间、平均住院天数与单用头孢他啶组比较,差异均有显著性(P<0.05,P<0.01),WBC总数、中性粒细胞分类正常的平均时间之间差异无显著性。结论:头孢他啶联合双黄连治疗COPD合并下呼吸道感染疗效较高,副作用小,有很好的临床价值。

关键词：肺疾病,慢性阻塞性/并发症呼吸道感染/药物疗法头孢他啶/治疗应用金银花/治疗应用连翘/治疗应用黄芩/治疗应用

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泰能与头孢他啶治疗老年严重细菌感染疗效观察

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中国误诊学杂志 2006年第5期6卷 892-893页

作者：岳玉桃赵崇高楚雅玲郑灵芝河南科技大学第一附属医院河南洛阳471003

我院1999-06－2004-06收治的老年严重细菌感染患者,首选头孢他啶治疗,多数疗效良好;治疗无效者,改用泰能后疗效满意,现报道如下。[第一段]

关键词：亚胺培南/治疗应用西司他丁/治疗应用头孢他啶/治疗应用细菌感染/药物疗法

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头孢西丁钠和头孢他啶治疗肺部感染疗效对比

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中国误诊学杂志 2006年第3期6卷 455-456页

作者：王琨沃雪王蕊张培林黑龙江省昆仑医药有限责任公司黑龙江哈尔滨150001 哈尔滨医科大学第二临床医学院黑龙江哈尔滨150080 黑龙江省皮肤病防治所黑龙江哈尔滨150001 重庆市第九人民医院 400700

近来,我们对头孢西丁钠进行了临床疗效、细菌学检查及不良反应观察。并选用头孢他啶作为随机对照。现将结果报告如下。[第一段]

关键词：肺炎/药物疗法头孢西丁/治疗应用头孢他啶/治疗应用

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Serum bactericidal and inhibitory titres in the management of melioidosis

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JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 2000年第1期45卷 123-127页

作者： Simpson, AJH Dance, DAB Wuthiekanun, V White, NJ Mahidol Univ Fac Trop Med Bangkok 10400 Thailand Univ Oxford John Radcliffe Hosp Nuffield Dept Clin Med Ctr Trop Med Oxford OX3 9DU England

A retrospective evaluation of the relationship between serum bactericidal and inhibitory titres and treatment outcome in 195 adult Thai patients with severe melioidosis was conducted. Drug regimens included ceftazidime (52% of patients), co-amoxiclav (24%), imipenem (11%) or the conventional four-drug combination (11%). Pre- and 1 h post-dose serum samples were collected after 48-72 h of therapy, and serum inhibitory and bactericidal titrations determined. Median post-dose titres were: bactericidal 1:8 (range 0-1:128) and inhibitory 1:16 (range 0-1:128). Overall mortality was 26% and outcome was not influenced by either inhibitory or bactericidal titres. Pre-dose titres correlated with renal function;renal function was the most important predictor of mortality. Determination of serum inhibitory or bactericidal titres is unhelpful in the management of severe melioidosis.

关键词：抗菌药/血液抗菌药/药理学抗菌药/治疗应用伯霍尔德杆菌类鼻疽/药物作用头孢他啶/血液头孢他啶/药理学头孢他啶/治疗应用药物疗法联合/血液药物疗法联合/治疗应用亚胺培南/血液亚胺培南/药理学亚胺培南/治疗应用肾功能试验住院时间类鼻疽/药物疗法类鼻疽/微生物学回顾性研究血清杀菌试验治疗结果人类中年人

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Prognostic value of cytokine concentrations (tumor necrosis factor-α, interleukin-6, and interleukin-10) and clinical parameters in severe melioidosis

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JOURNAL OF INFECTIOUS DISEASES 2000年第2期181卷 621-625页

作者： Simpson, AJH Smith, MD Weverling, GJ Suputtamongkol, Y Angus, BJ Chaowagul, W White, NJ van Deventer, SJH Prins, JM Mahidol Univ Fac Trop Med Bangkok 10400 Thailand Sappasitprasong Hosp Dept Med Ubon Ratchathani Thailand Univ Oxford John Radcliffe Hosp Nuffield Dept Clin Med Ctr Trop Med Oxford OX3 9DU England Univ Amsterdam Acad Med Ctr Dept Clin Epidemiol & Biostat NL-1105 AZ Amsterdam Netherlands Univ Amsterdam Acad Med Ctr Dept Expt Internal Med NL-1105 AZ Amsterdam Netherlands Univ Amsterdam Acad Med Ctr Dept Infect Dis Trop Med & AIDS NL-1105 AZ Amsterdam Netherlands

Raised serum concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, or IL-10 are associated with mortality in patients with sepsis, but it is not known whether elevated cytokine levels are independently predictive of mortality. Cytokine assays (TNF-alpha, IL-6, and IL-10) were performed on admission plasma samples from 172 adult Thai patients with severe melioidosis. Mortality was 31.4%. APACHE II score;septicemia;plasma lactate;TNF-alpha, IL-6, and IL-10 concentrations;and IL-10/TNF-alpha and IL-6/IL-10 ratios were each associated with outcome (P less than or equal to .001 for all variables). Only the APACHE II score and either IL-6 or IL-10 concentration were independent predictors of mortality, as determined by use of multiple logistic regression (with cytokine concentrations and ratios entered separately). In a multivariate analysis, including both IL-6 and IL-10, the IL-10 concentration was no longer predictive. Therefore, APACHE II scores and either IL-6 or IL-10 concentration may be the most reliable parameters for stratification of patients in future studies of severe gramnegative sepsis.

关键词：急性病生理学和长期健康评价菌血症/微生物学生物学标记/血液伯霍尔德杆菌类鼻疽/分离和提纯头孢他啶/治疗应用头孢菌素类/治疗应用细胞因子类/血液亚胺培南/治疗应用白细胞介素10/血液白细胞介素6/血液乳酸盐类/血液 Logistic模型类鼻疽/诊断类鼻疽/药物疗法类鼻疽/免疫学类鼻疽/死亡率预后噻烯霉素类/治疗应用肿瘤坏死因子α/代谢青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Melioidosis presenting as urinary tract infection in a previously healthy tourist

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SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2000年第1期32卷 92-93页

作者： Carlson, P Seppänen, M Univ Helsinki Cent Hosp HUCH Diagnost Div Bacteriol Helsinki Finland Univ Helsinki Cent Hosp Dept Med Div Infect Dis Helsinki Finland

Melioidosis is a tropical disease caused by Burkholderia pseudomallei, which is common in southeast Asia and Australia, but which is rarely diagnosed in Scandinavia. An increasing number of cases are being reported among tourists to infected areas. We report the first Finnish case of melioidosis, which presented as urinary tract infection in a previously healthy male tourist.

关键词：抗感染药泌尿系/治疗应用抗体特异性类鼻疽伯霍尔德杆菌/免疫学类鼻疽伯霍尔德杆菌/分离和提纯头孢他啶/药理学头孢他啶/治疗应用头孢菌素类/治疗应用药物疗法联合酶联免疫吸附测定免疫球蛋白G/血液类鼻疽/药物疗法类鼻疽/免疫学类鼻疽/微生物学微生物敏感性试验旅行治疗结果泌尿道感染/药物疗法泌尿道感染/免疫学泌尿道感染/微生物学人类男(雄)性中年人

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In vitro and in vivo influence of adjunct clarithromycin on the treatment of mucoid Pseudomonas aeruginosa

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JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 2000年第1期45卷 57-62页

作者： Bui, KQ Banevicius, MA Nightingale, CH Quintiliani, R Nicolau, DP Hartford Hosp Dept Pharm Res Hartford CT 06102 USA Hartford Hosp Off Res Adm Hartford CT 06102 USA Hartford Hosp Div Infect Dis Hartford CT 06102 USA

Recent in vitro and in vivo data have substantiated the beneficial effects of macrolides/azalides for use against Pseudomonas aeruginosa. While macrolides/azalides are not very potent in vitro antimicrobial agents against this pathogen, they appear to have an adjunctive role by either altering the course of infection owing to their inhibition of biofilm production or modulation of the host anti-inflammatory response, or both. To determine the in vitro and in vivo effects of clarithromycin as adjunctive therapy with ceftazidime against a mucoid-producing strain of P. aeruginosa, we performed a standard time-kill experiment and a pneumonia model in mice, respectively. Time-kill studies were performed over a 24 h period with varying concentrations of clarithromycin and ceftazidime alone or in combination. Synergic activity was noted with the use of 0.5 x MIC of ceftazidime combined with either 0.5 or 2 x MIC of clarithromycin. Neutropenic mice were infected with 10(8) cfu of mucoid P. aeruginosa intranasally to produce pneumonia and subsequently treated with oral clarithromycin (100 mg/kg) and/or sc ceftazidime (1500 mg/kg) as monotherapy or in combination. The addition of 5 days of clarithromycin to the ceftazidime regimen significantly improved survival as compared with the beta-lactam alone (48% versus 32%, P = 0.04). While a statistically significant difference was not detected with the addition of 3 days of clarithromycin therapy, a trend towards improved survival was noted with this regimen (38% versus 32%). These data demonstrate the adjunctive potential of clarithromycin when administered in combination with an antipseudomonal agent for the treatment of mucoid-producing Pseudomonas in acute respiratory infection.

关键词：抗菌药/药理学抗菌药/治疗应用头孢他啶/药理学头孢他啶/治疗应用头孢菌素类/药理学头孢菌素类/治疗应用克拉霉素/药理学克拉霉素/治疗应用疾病模型动物药物疗法联合/药理学药物疗法联合/治疗应用微生物敏感性试验肺炎细菌性/药物疗法肺炎细菌性/微生物学假单胞菌感染/药物疗法假单胞菌感染/微生物学假单胞菌铜绿/药物作用时间因素动物女(雌)性人类小鼠

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A comparative trial of imipenem versus ceftazidime in the release of endotoxin and cytokine generation in patients with Gram-negative urosepsis

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JOURNAL OF ENDOTOXIN RESEARCH 2000年第1期6卷 25-31页

作者： Luchi, M Morrison, DC Opal, S Yoneda, K Slotman, G Chambers, H Wiesenfeld, H Lemke, J Ryan, JL Horn, D Univ Kansas Med Ctr Dept Med 6080F Div Infect Dis Kansas City KS 66160 USA St Lukes Hosp Off Res Adm Kansas City MO 64111 USA Brown Univ Mem Hosp Sch Med Pawtucket RI 02860 USA Calif State Univ Sacramento Davis Med Ctr Sacramento CA 95819 USA Rutgers State Univ Med Ctr Cooper Hosp Dept Surg Camden NJ 08102 USA San Francisco Gen Hosp San Francisco CA 94110 USA Magee Womens Hosp Dept OB GYN RS Pittsburgh PA USA Univ Iowa Coll Med Dept Prevent Med & Environm Hlth Iowa City IA 52242 USA Genet Inst Inc Cambridge MA 02140 USA Bristol Myers Squibb Co Plainsboro NJ USA

Evidence from in vitro experiments and animal and human studies indicate that antibiotic therapy may induce the release of endotoxin from the outer membrane of Gram-negative bacteria. Antibiotics that bind preferentially to penicillin-binding protein-2 (PBP-2) -such as imipenem - are associated with little release of endotoxin, while antibiotics that preferentially bind to PBP-3 - such as ceftazidime - are associated with far greater release of endotoxin. We conducted a randomized, multicenter, double-blind study comparing imipenem to ceftazidime in patients with urinary tract infections caused by Gram-negative bacilli associated with signs and symptoms of systemic inflammation. A total of 33 patients were randomized to receive either imipenem (n = 14) or ceftazidime (n = 19) for initial treatment for urosepsis. No differences in plasma endotoxin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) or urine endotoxin, IL-6 or IL-8 levels were found between the two treatment groups within the first 8 h after antibiotic administration. We conclude that, if differences exist with respect to endotoxin release by these two antimicrobial agents, these differences an not readily demonstrable in this clinical study with carefully defined patients with Gram-negative urinary tract infections.

关键词：抗菌药/治疗应用头孢他啶/治疗应用细胞因子类/代谢双盲法内毒素类/代谢革兰氏阴性菌感染/药物疗法亚胺培南/治疗应用脓毒症/药物疗法脓毒症/微生物学泌尿道感染/药物疗法泌尿道感染/微生物学成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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