Ertapenem可安全有效地治疗腹腔内感染


  Feb. 6, 2003 - 根据一项发表于二月份「外科年监(Annals of Surgery)」的第三期双盲、随机临床试验显示,每天服用1次Ertapenem与每天服用4次的piperacillin(商品名tazobactam)一样能有效治疗腹腔内感染,且患者的耐受性良好。
  
  来自美国俄亥俄州Cincinnati大学医学院,同时也是017研究计画小组(Protocol 017 Study Group)成员的Joseph S. Solomkin博士表示,就药物动力学或抗微生物的有效范围来看,每天使用一次Ertapenem可有效治疗一般好氧与厌氧微生物的感染。
  
  Ertapenem是新的beta-lactam制剂,可广泛对抗一般腹腔内感染的病菌,在这次修改后的随机分组试验中,633位受到广泛性感染的患者中,经过评估后共有396位(约60%)罹患穿孔性或脓疡性的盲肠炎。
  
  在随机分组试验中,ertapenem的治癒率为79.3%(311 位患者中有245位治癒),以piperacillin治疗的患者,其治癒率为76.2%(304位患者中有232位治癒);而ertapenem对一般微生物感染的治癒率为86.7%(203 位患者中有176位治癒),piperacillin的治癒率为81.2%(193 位患者中有157位治癒)。
  
  在小组讨论中,大家都认为应在疾病开始时即介入治疗,一般来说,患者对Ertapenem的耐受性与安全性都与piperacillin一样好。
  
  这次的研究显示,每天使用1克的ertapenem来治疗广泛性的腹腔内感染,相当于每6小时使用一次3.375克piperacillin的效果,因此对于治疗腹腔内感染的新手医师,为避免同时使用不同的药物治疗或需要多次给药的抗生素,ertapenem或许能成为另一种治疗的新选择。
  
  

Ertapenem Safe, Effective in I

By Laurie Barclay, MD
Medscape Medical News

Feb. 6, 2003 — Ertapenem once daily was as efficacious and well tolerated for intra-abdominal infections as piperacillin/tazobactam four times daily, according to the results of a phase III, double-blind randomized trial reported in the February issue of Annals of Surgery.

"Ertapenem has a pharmacokinetic profile and antimicrobial spectrum that support the potential for use as a once-a-day agent for the treatment of common mixed aerobic and anaerobic infections," write Joseph S. Solomkin, MD, from the University of Cincinnati College of Medicine in Ohio, and colleagues from the Protocol 017 Study Group.

Ertapenem is a novel beta-lactam agent with wide activity against common pathogens responsible for intra-abdominal infections. Of 633 patients with a wide range of infections included in the modified intent-to-treat population, 396 were evaluable, and approximately 60% of these had perforated or abscessed appendicitis.

Cure rates in the modified intent-to-treat groups were 79.3% (245 of 311 patients) for ertapenem and 76.2% (232 of 304 patients) for piperacillin/tazobactam. Cure rates for microbiologically evaluable patients were 86.7% (176 of 203 patients) for ertapenem and 81.2% (157 of 193 patients) for piperacillin/tazobactam.

An expert panel review ensured the adequacy of the initial intervention. Ertapenem was generally well tolerated, with a similar safety and tolerability profile to that of piperacillin/tazobactam.

"In this study, the efficacy of ertapenem 1 g once a day was equivalent to piperacillin/tazobactam 3.375 g every six hours in the treatment of a range of intra-abdominal infections," the authors write. "The results of this trial suggest that ertapenem may be a useful option that could eliminate the need for combination and/or multidosed antibiotic regimens for the empiric treatment of intra-abdominal infections."

Merck & Co., Inc. supported this study.

Ann Surg. 2003;237:235-245

Reviewed by Gary D. Vogin, MD

    
相关报导
随机控制试验:非复杂性憩室炎可不使用抗生素
2016/10/24 下午 05:46:10
无并发症阑尾炎的孩童可以不用手术
2015/12/29 上午 10:06:27
阑尾炎:使用较长期的抗生素治疗可能没有帮助
2015/12/9 下午 02:53:46

上一页
   1   2   3   4   5   6   7   8   9   10  




回上一页