三种抗阳性菌药物比较教学课件.ppt

稳可信VS替考拉宁及利奈唑胺（药物的三大特性比较）;稳可信的有效性;重杀菌机制;稳可信上市 年全球仅出现 株耐药;重杀菌机制赋予万古霉素持久不变的敏感率``;作用于核糖体单一抑菌机制的利奈唑胺的耐药;所有金葡菌对万古霉素仍保持100%敏感率;国内葡萄球菌对万古霉素保持 敏感率;国内葡萄球菌对万古霉素保持 敏感率;利奈唑胺目前的MIC分布情况图; linezolid versus Vancomycin or Teicoplanin for Nosocomial Pneumonia: A Meta-Analysis AC. KALIL, M. H. MURTHY , E. HERMSEN , et al. Methods: Prospective, randomized trials which tested linezolid vs. vancomycin or teicoplanin for treatment of NP were included. Heterogeneity was analyzed by I2 and Q statistics. Relative Risks (RR) were based on the Mantel-Haenszel method. Outcomes analyzed included clinical cure (CC), microbiologic eradication (ME), and side effects. Results: 8 linezolid trials (6 vancomycin, 2 teicoplanin) were included (N=853). The linezolid vs glycopeptide analysis shows: CC RR=1.01(95% CI 0.93,1.10, p=0.80; I2=0%; N=853); ME RR=1.10 (CI 0.97,1.23; p=0.11; I2=0%; N=597); and MRSA population RR=1.14 (CI 0.82,1.58; p=0.44; I2=47%; N=191). If linezolid is compared to vancomycin only, the CC RR remains 1.01(CI 0.90,1.12), and ME and MRSA RRs are: 1.06 (CI 0.88,1.28) and 1.04 (CI 0.73,1.47), respectively. The risk of thrombocytopenia (RR=1.92 [CI 1.29,2.86]; p=0.001) and GI events (RR=1.90 [CI 1.04,3.48]; p=0.03) were significantly higher with linezolid, but no differences were seen for renal dysfunction (RR=0.82 [CI 0.52,1.27]; p=0.37), or all-cause deaths (RR=0.95 [CI 0.76,1.18]; p=0.63). ;万古霉素治疗MRSA感染疗效未被超越;万古霉素治疗MRSA起效时间未被超越;稳可信：众多权威指南推荐;稳可信的安全性;患者，疗效安全看得见！;利奈唑胺受到美国FDA的警告1;万古霉素纯度提高，肾毒性发生率大大减少 ;稳可信稀释后静脉滴注 药物浓度不超过 5毫克/毫升 每次滴注时间应该超过 60分钟 肾功能损害及年长患者应调整剂量 必要时监测血药浓度 经常改变输注部位;*;*;万古霉素与替考拉宁安全性比较;万古霉素治疗MRSA感染副反应发生率与利奈唑胺比较;*; linezolid versus Vancomycin or Teicoplanin for Nosocomial Pneumonia: A Meta-Analysis AC. KALIL, M. H. MURTHY , E. HERMSEN , et al. Methods: Prospective, randomized trials which tested linezolid vs. vancomycin or teicoplanin for treatment of NP were included. Heterogeneity was