比較Linezolid與Glycopeptides對具Methicilin抗藥性金黃色葡萄球菌肺炎的療效

Linezolid v.s. Glycopeptides for the Treatment of Methiciline-resistant Staphylococcus aureus Pneumonia

謝効烝(Hsiao-Cheng Hsieh) ； 盧柏樑(Po-Liang Lu) ； 陳彥旭(Yen-Hsu Chen)

《內科學誌》 22卷3期 (2011/06) Pp. 153-160

https://doi.org/10.6314/JIMT.2011.22(3).02

摘要

抗甲氧苯青黴素金黃色葡萄球菌(Methicilin-resistant Staphylococcus aureus)是院內肺炎常見之菌種之一，但現今臨床醫師一直爲糖肽類抗生素(glycopeptides)治療methicilin-resistant Staphylococcus aureus (MRSA)肺炎的高失敗率所困擾；因此，新一代可對抗MRSA的抗生素(linezolid)是否可用於肺炎令人寄予厚望，本篇綜論就此議題作進一步的整理。近年來，部分研究比較利奈唑胺(linezolid)與萬古黴素(vancomycin)運用於MRSA肺炎治療之效果，其顯示linezolid的臨床治癒率、存活率和細菌清除率似乎高於vancomycin；但是最近的兩篇統合分析(meta-analysis)卻又發現兩者在臨床治癒率、存活率和細菌清除率卻沒有統計學上之差別。因此，目前仍需更進一步的隨機對照組試驗(randomized controlled trial, RCT)提供更多資訊以釐清何者對MRSA肺炎的臨床效益較佳。

關鍵字

MRSA肺炎 ； 利奈唑胺 ； 萬古黴素 ； 糖肽類抗生素

並列摘要

Methicilin-resistant Staphylococcus aureus is one of common pathogen in nosocomial pneumonia. Higher failure rate of treatment in methicilin-resistant Staphylococcus aureus (MRSA) pneumonia has been a major challenge for clinical physicians. Whether new antibiotics (linezolid) for MRSA could treat pneumonia is expected greatly. Recent studies of comparing linezolid versus vancomycin in the treatment of MRSA pneumonia revealed that the rates of clinical cure, survival and microbiological eradication seem to be higher in linezolid group. But recent two meta-analysis disclose no significant difference of clinical cure, survival and bacterial response between these two antibiotics. Further randomized, controlled trials (RCT) would be needed to provide more information on clinical efficacy of these antibiotics for MRSA pneumonia.

並列關鍵字

MRSA pneumonia ； Linezolid ； Vancomycin ； Glycopeptides