替加环素治疗107例粒细胞缺乏合并感染血液病患者的临床观察

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.