Clinical Efficacy And Safety Analysis Of Tegacycline In The Treatment Of Severe Community-acquired Pneumonia

Objective: The clinical treatment of Severe community-acquired pneumonia(SCAP)is difficult and the mortality rate is high.Therefore,prompt diagnosis and early treatment are particularly important.Tetracycline is a newly applied clinical antibiotic.In addition to pseudomonas aeruginosa,Tetracycline has good anti-infection effects in nearly all pathogens causing community-acquired pneumonia(CAP),SCAP and Hospital acquired pneumonia(HAP).To analyze the efficacy and safety of tetracycline in the treatment of SCAP,and to provide reference for the rational application of tetracycline in SCAP.Methods: Retrospective analysis in January 2017-June 2018 patients with diagnosis of SCAP,and apply for plus a complete ring element anti-infection treatment cases,investigating the general situation,laboratory examination,clinical symptoms,basic diseases,treatment,medication,medication time after the adverse reactions of clinical data,evaluate the clinical efficacy and safety,and descriptive statistics analysis was carried out on the data collected.Result:1.General information of the patients: a total of 28 patients met the inclusion criteria,including 19 males(67.86%)and 9 females(32.14%),aged 58.25±20.16(15-91)years old,with an average length of stay of 22.57±13.29(7-62)days,and an average course of treatment of tetracycline of 10.73 ± 4.42(3-18)days.There were 24 cases(85.71%),19 cases(67.86%)and 12 cases(42.86%)with fever,cough and expectoration.Fever for patients with high fever,the average temperature at 39.06±0.91 ?(37.4 ~41.0).Most of the respiratory symptoms were the first symptoms upon admission.Among the 28 patients,there were 5 patients with pathogenicity,including 1 patient with positive sputum culture,and staphylococcus aureus was isolated.There was 1 case of positive culture of blood bacteria and staphylococcus aureus was isolated.Legionella urine antigen positive 1 case,mycoplasma antibody IgM positive 1 case,chlamydia IgM positive 1 case.2.Clinical efficacy and prognosis: twenty-eight patients enrolled in this study whowere treated with tetracycline received the dose of tetracycline doubled for the first time(i.e.,the first day of tetracycline 100 mgQd,followed by tetracycline 50mgQ12).Among the 28 patients,16 improved,8 died and 4 had uncertain outcome.After removing the cases with uncertain outcome,the effective rate and the ineffective rate were 66.67% and33.33% respectively.In the treatment regimens of 16 patients with clinical success,the initial treatment was mainly the use of fluoroquinolones,imipenem,-lactam,macrolides and other antibacterial drugs,and after the treatment effect was not good,the treatment was changed to tetracycline.3.Among the 28 enrolled patients,a total of 21(75.00%)patients had adverse reactions,including 1(3.57%)with nausea and vomiting,2(7.14%)with diarrhea,1(3.57%)with abdominal pain,1(3.57%)with dyspepsia,9(32.14%)with elevated BUN,4(14.28%)with elevated ALP,and 3(10.71%)with bilirubinemia.This study indicated that after the application of tetracycline,the patients' digestive system adverse reactions were obvious.In this study,there were no cases of discontinuation of tetracycline treatment due to adverse reactions.After the occurrence of adverse reactions were symptomatic treatment,the use of tetracycline adverse reactions are mild and controllable.Conclusion:Tetracycline has a good clinical effect on SCAP with a high cure rate,especially for patients who failed the initial treatment.Adverse reactions occurred in patients with SCAP treated with tetracycline,which were obvious in the digestive system.However,in this study,adverse reactions of patients were all improved after symptomatic treatment.No patients were treated with tetracycline due to adverse reactions,indicating that the adverse reactions caused by the application of tetracycline were mild and controllable.