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Eur Respir J:用美罗培南/克拉维酸治疗耐多药结核病和超级耐多药结核病的有效性、安全性分析

2016-11-21 xing.T MedSci原创

在病情更加严重的病例中,其在临床预后和细菌转化率方面与对照组无明显差异可能暗示美罗培南/克拉维酸在治疗耐多药结核病和超级耐多药结核病例更有效。

至今为止,尚未有大型的研究来评估用美罗培南/克拉维酸治疗耐多药结核病和超级耐多药结核病的有效性、安全性和耐受性。来自于英国的研究人员在呼吸疾病领域权威杂志Eur Respir J上发表一篇研究文章,该研究旨在评估在耐多药结核病和超级耐多药结核病患者接受基础治疗方案时加上美罗培南/克拉维酸治疗的效果、安全性和耐受性。

研究人员发现相比于未加入美罗培南/克拉维酸进行治疗的患者(n=168例),接受抗结核病基础治疗方案加入美罗培南/克拉维酸进行治疗的患者(n=96)表现出较广泛的耐药谱:在加入美罗培南/克拉维酸的抗结核治疗组中超级耐多药结核病更为频繁(49% vs. 6%,P<0.0001)并且具有的抗生素抗性数量的中位数(四分位间距)明显增加(8(6-9)vs. 5(4-6))。结核病患者加入美罗培南/克拉维酸治疗时间的中位数(四分位间距)为85天(49-156天)。在耐多药结核病的整体队列以及有无超级耐多药结核病的亚组中并未观察到统计学上的显著差异;特别是,在加入了美罗培南/克拉维酸治疗的超级耐多药结核病患者痰涂片和培养转化率结果与对照组相似(分别为88% vs. 100%,P=1.00和88% vs. 100%,P=1.00)。该研究中仅有6例病例(其中四例患者重新开始治疗)报道了因美罗培南/克拉维酸引起的不良事件。

在病情更加严重的病例中,其在临床预后和细菌转化率方面与对照组无明显差异可能暗示美罗培南/克拉维酸在治疗耐多药结核病和超级耐多药结核病例更有效。

原始出处:

Tiberi S, et al. Effectiveness and safety of meropenem/clavulanate-containing regimens in the treatment of MDR- and XDR-TB. Eur Respir J. 2016 Apr;47(4):1235-43. doi: 10.1183/13993003.02146-2015.

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    2016-12-05 angel2112

    有这个药,疗效如何

    0

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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-12-05 angel2112

    新药?

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-11-22 zibozhouping

    现在这类病人有所增加

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1651397, encodeId=deae165139ebc, content=<a href='/topic/show?id=4b64e998681' target=_blank style='color:#2F92EE;'>#美罗培南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79986, encryptionId=4b64e998681, topicName=美罗培南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=061b24191563, createdName=fanweitanzhen, createdTime=Sat Nov 26 09:52:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2052526, encodeId=baf020525267d, content=<a href='/topic/show?id=a03f288e664' target=_blank style='color:#2F92EE;'>#克拉维酸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28876, encryptionId=a03f288e664, topicName=克拉维酸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c82369, createdName=jiekemin, createdTime=Sat Mar 25 18:52:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160508, encodeId=51fe16050864, content=有这个药,疗效如何, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:24:29 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160507, encodeId=37cd16050ec4, content=新药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:23:58 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254022, encodeId=fec21254022d9, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458400, encodeId=bd7d1458400f6, content=<a href='/topic/show?id=a39f803557a' target=_blank style='color:#2F92EE;'>#耐多药结核病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80355, encryptionId=a39f803557a, topicName=耐多药结核病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa6e6064686, createdName=mgqwxj, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157481, encodeId=c24315e481ae, content=现在这类病人有所增加, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160601/IMG574E13FEE55F33222.jpg, createdBy=929c1478678, createdName=zibozhouping, createdTime=Tue Nov 22 20:35:07 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157452, encodeId=595115e45232, content=讲的好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Nov 22 13:35:18 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157369, encodeId=5ffc15e3691d, content=但愿如此吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Tue Nov 22 04:11:26 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157363, encodeId=bdaa15e363c0, content=谢谢了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-11-22 虈亣靌

    讲的好学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1651397, encodeId=deae165139ebc, content=<a href='/topic/show?id=4b64e998681' target=_blank style='color:#2F92EE;'>#美罗培南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79986, encryptionId=4b64e998681, topicName=美罗培南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=061b24191563, createdName=fanweitanzhen, createdTime=Sat Nov 26 09:52:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2052526, encodeId=baf020525267d, content=<a href='/topic/show?id=a03f288e664' target=_blank style='color:#2F92EE;'>#克拉维酸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28876, encryptionId=a03f288e664, topicName=克拉维酸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c82369, createdName=jiekemin, createdTime=Sat Mar 25 18:52:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160508, encodeId=51fe16050864, content=有这个药,疗效如何, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:24:29 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160507, encodeId=37cd16050ec4, content=新药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:23:58 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254022, encodeId=fec21254022d9, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458400, encodeId=bd7d1458400f6, content=<a href='/topic/show?id=a39f803557a' target=_blank style='color:#2F92EE;'>#耐多药结核病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80355, encryptionId=a39f803557a, topicName=耐多药结核病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa6e6064686, createdName=mgqwxj, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157481, encodeId=c24315e481ae, content=现在这类病人有所增加, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160601/IMG574E13FEE55F33222.jpg, createdBy=929c1478678, createdName=zibozhouping, createdTime=Tue Nov 22 20:35:07 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157452, encodeId=595115e45232, content=讲的好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Nov 22 13:35:18 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157369, encodeId=5ffc15e3691d, content=但愿如此吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Tue Nov 22 04:11:26 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157363, encodeId=bdaa15e363c0, content=谢谢了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-11-22 深海的鱼

    但愿如此吧!

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1651397, encodeId=deae165139ebc, content=<a href='/topic/show?id=4b64e998681' target=_blank style='color:#2F92EE;'>#美罗培南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79986, encryptionId=4b64e998681, topicName=美罗培南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=061b24191563, createdName=fanweitanzhen, createdTime=Sat Nov 26 09:52:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2052526, encodeId=baf020525267d, content=<a href='/topic/show?id=a03f288e664' target=_blank style='color:#2F92EE;'>#克拉维酸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28876, encryptionId=a03f288e664, topicName=克拉维酸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c82369, createdName=jiekemin, createdTime=Sat Mar 25 18:52:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160508, encodeId=51fe16050864, content=有这个药,疗效如何, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:24:29 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160507, encodeId=37cd16050ec4, content=新药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=462144269, createdName=angel2112, createdTime=Mon Dec 05 22:23:58 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254022, encodeId=fec21254022d9, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458400, encodeId=bd7d1458400f6, content=<a href='/topic/show?id=a39f803557a' target=_blank style='color:#2F92EE;'>#耐多药结核病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80355, encryptionId=a39f803557a, topicName=耐多药结核病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa6e6064686, createdName=mgqwxj, createdTime=Wed Nov 23 09:52:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157481, encodeId=c24315e481ae, content=现在这类病人有所增加, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160601/IMG574E13FEE55F33222.jpg, createdBy=929c1478678, createdName=zibozhouping, createdTime=Tue Nov 22 20:35:07 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157452, encodeId=595115e45232, content=讲的好学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Nov 22 13:35:18 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157369, encodeId=5ffc15e3691d, content=但愿如此吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Tue Nov 22 04:11:26 CST 2016, time=2016-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=157363, encodeId=bdaa15e363c0, content=谢谢了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Tue Nov 22 00:51:34 CST 2016, time=2016-11-22, status=1, ipAttribution=)]
    2016-11-22 txqjm

    谢谢了,学习了

    0

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