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目的了解碳青霉烯类抗生素对临床常见致病菌的体外抗菌活性并评价其治疗肺部感染的疗效。方法采用琼脂二倍稀释法测定帕尼培南/倍他米隆、亚安培南/西司他丁、美罗培南对242株临床分离菌的最低抑菌浓度(minimal inhibitory concentration,MIC),及对部分菌株的最低杀菌浓度(minimal bactericidal concentration,MBC)。分别对20例、18例及16例肺部感染患者使用帕尼培南/倍他米隆、亚安培南/西司他丁、美罗培南500mg加生理盐水100ml,12h1次,静脉点滴,疗程3~7d。结果三者对临床常见的G-和G+致病菌都有很强的抗菌活性,作用相仿。帕尼培南/倍他米隆对G+菌的抗菌活性最强,美罗培南对G-菌的抗菌活性较其余二者强2~8倍。经三者治疗后细菌转阴率分别为78%、89%及94%;治疗肺部感染的有效率分别为75%、83%及88%。结论三者对临床常见致病菌的体外抗菌活性强,抗菌作用相仿,对肺部感染均有较好疗效,安全性好。
Objective To understand the antibacterial activity of carbapenems against common pathogens in clinical practice and to evaluate its efficacy in the treatment of pulmonary infection. Methods The minimum inhibitory concentration (MIC) of 242 clinical isolates of panipenem / betamipron, melamine / cilastatin, and meropenem were determined by agar dilution method. Some strains of the minimum bactericidal concentration (minimal bactericidal concentration, MBC). 20 cases, 18 cases and 16 cases of pulmonary infection were treated with panipenem / betamethasone, melamine / cilastatin, meropenem 500mg plus saline 100ml, 12h1 times, intravenous drip, treatment 3 ~ 7d. The results of the three common clinical G- and G + pathogenic bacteria have strong antibacterial activity, the role of similar. The antibacterial activity of panipenem / betamipron was the strongest for G +, and the antibacterial activity of meropenem against G- bacteria was 2-8 times stronger than that of the other two. After the three treatments, the negative rates of bacteria were 78%, 89% and 94% respectively. The effective rates of treating lung infection were 75%, 83% and 88% respectively. Conclusion The three of the common clinical pathogenic bacteria in vitro antibacterial activity, similar antibacterial effect, have a good effect on lung infection, good safety.