Objective: To observe the curative effect and side effect of tigecycline in the treatment of patients with infection caused by granulocytopenia.
Methods: The clinical data of 107 patients who were treated with tigecycline for infection due to granulocytopenia were retrospectively reviewed. The tigecycline was administered by intravenously (30-60 min drip infusion)as the initial dose of 100 mg and maintenance does of 50 mg, every 12h. The whole treatment course kept for 5-7 d when the body temperature was normal and then the step-down treatment or discontinuation of the drug was adopted.
Results: A total of 104 strains of bacteria were isolated from 107 cases of hospitalized patient, including 60 multi-drug resistant strains (MDR) and 2 extensively-drug resistant strains (XDR). The total effective rate of tigecycline treatment was 62.6%, including 30 cases with tigecycline alone (63.3% of the effective rate), 21 cases with tigecycline as initial treatment followed by combination with other antibiotics (61.9% of the effective rate), and 56 cases with tigecycline in combination with other antibiotics from the beginning of the treatment (62.5% of the effective rate). There was no statistical significant difference between the 3 treatment groups (P=0.994). Among the 39 patients with MDR strains, 22 patients' temperature was controlled , 9 patients died, and 8 patients' temperature remained uncontrolled. The clinical effective rate of these patients was 56.4%. The median onset time of tigecycline treatment was 3 days. The adverse drug reactions of nausea (11.2% ) and vomiting (8.4% )were tolerable.
Conclusion: Tigecycline is effective in treatment of resistant bacteria infection in patients with granulocytopenia. The side effects of tigecycline were few, safe and generally well tolerated.
目的: 观察替加环素治疗粒细胞缺乏合并感染血液病患者的疗效和安全性。
方法: 回顾性分析107例使用替加环素治疗粒细胞缺乏并感染血液病患者的临床资料，替加环素初始剂量100 mg，维持剂量50 mg，每12 h 1次，30~60 min静脉滴注完毕，患者体温正常5~7 d后开始予抗菌药物降阶梯治疗或停药。
结果: 107例患者住院期间共分离出病原菌104株，其中多重药耐菌株（MDR）60株，泛耐药菌株（XDR）2株。全部107例患者中，30例单用替加环素，21例初始单用替加环素后联合其他抗菌药物，56例初始即替加环素联合其他抗菌药物，3组患者治疗有效率分别为63.3%、61.9％及62.5%，差异无统计学意义（P=0.994），替加环素治疗总有效率为62.6%。39例分离出MDR的患者中，22例体温得到控制，8例体温未得到控制，9例死亡，临床有效率为56.4%。替加环素起效的中位时间为3 d。不良反应以恶心（11.2%）、呕吐（8.4%）为主，均可以耐受。
结论: 替加环素治疗粒细胞缺乏血液病患者耐药菌感染具有较好的疗效，引发的不良反应少，安全可耐受。