Clinical Effect Of Tigecycline In The Treatment Of Hospital Acquired Pneumonia And Evidence-based Pharmacy

Objective To explore the clinical efficacy of tigecycline in the treatment of hospital acquired pneumonia and provide reference for clinical practice with tigecycline.Methods The treatment of 24 cases with hospital acquired pneumonia caused from January 2014 to December 2016 were retrospectively analyzed,and the use of tigecycline anti-infective treatment to assess its clinical efficacy and bacterial clearance.Results 24 subjects were enrolled in this study,the average age was 69.3 ± 11.81 years,the average hospital stay was 31.7 ± 9.1 days,the average delivery time was 11.7 ± 3.5 days,and the average APACHE II score was 20.0 ± 5.0.Of the 24 patients,23 were cultured in Acinetobacter baumannii.In 23 cases of Acinetobacter baumannii,the resistance rate of Amikacin was 100%,the rate of Ampicillin Sulbactam was 100%,Ciprofloxacin resistant rate of 100%,Imipenem resistance rate of 100%,Meropenem resistance rate of 100%,Levofloxacin resistance rate of 91.30%,Tazobactam Sodium resistance rate of 90.91%,Cefopcrazone Sulbactam resistance rate of 82.61%,Minocycline resistance rate of 39.13%,t find r tigecycline are sensitive.24 patients were treated with tigecycline and other antibiotics in combination.The most commonly used combination of carburicenes(22.5%)and Cefoperazone Sulbactam(20%).In 24 patients,the clinical effective rate of 46.25%(n=11),bacterial clearance rate of 25%(n=6)and the mortality rate of 37.5%(n=9).Conclusion Use of tigecycline can have a positive impact for the treatment of hospital-acquired pneumonia,combination groups may have better effect.Objective To evaluate the efficacy,bacteriologic success and adverse reactions of tigecycline to treat hospital-acquired pneumonia by Meta-analysis method.Methods Pub Med?Medline?EBSCOhost?CNKI?VIP and Wanfang databases were searched.A controlled study was conducted to evaluate the treatment of hospital-acquired pneumonia.A meta-analysis was performed with Cochrane Collaboration's Rev Man 5.0 software.Results 15 studies were enrolled,including 8 randomized controlled trialstudies and 7 retrospective studies.Pooled analysis showed that,and the clinical efficacy was significantly higher than that of the control group(OR = 1.68,95% CI [1.26,2.25],P <0.05);the clinical efficacy was significantly higher than that of the control group(OR = 1.68,95% CI [1.26,2.25],P <0.05);the overall mortality rate was better than that of the control group(non-TGC)(SMD =-2.51,95% CI [-2.72,-2.29],P <0.05);and the ICU time was better than that of the control group(OR = 0.55,95% CI [0.37,0.83],P < 0.05),but the adverse reaction,the total length of stay between in the two groups was no significant difference.Subgroup analysis showed that the effective rate and bacterial clearance rate were not superior to those of the control group(non-TGC)when treated with VAP.The single drug treatment of HAP was not superior to the control group(non-TGC).Clusions Tigecycline can be used to treat hospital-acquired pneumonia,combination groups have better effect.But more high-quality RCTS are needed.