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目的观察高剂量达托霉素挽救性治疗血液病感染患者的临床疗效及安全性。方法回顾性分析19例血液病感染患者使用达托霉素挽救性治疗(剂量>6 mg/kg)的临床资料。感染类型包括多发皮肤软组织感染11例、导管相关血流感染1例、肝脓肿1例、长期发热可疑血流感染6例。结果达托霉素中位剂量7.8(6.3~10.4)mg/kg,中位疗程9(2~82)d。治愈8例,改善4例,失败3例,无法评价4例,临床有效率63.2%。感染类型、粒细胞缺乏及达托霉素剂量与疗效无关,而达托霉素疗程与疗效有关。除1例因肌酸磷酸激酶升高停止用药外,其余患者均耐受性良好。结论高剂量达托霉素挽救性治疗血液病感染患者,具有较好的临床疗效和安全性。
Objective To observe the clinical efficacy and safety of high-dose daptomycin in the treatment of patients with blood-borne infections. Methods The clinical data of 19 patients with blood-borne infection who underwent salvage therapy with Daptomycin (dose> 6 mg / kg) were retrospectively analyzed. Infection types include multiple skin and soft tissue infections in 11 cases, catheter-related bloodstream infection in 1 case, liver abscess in 1 case, long-term fever suspicious bloodstream infection in 6 cases. Results The median dose of daptomycin was 7.8 (6.3 ~ 10.4) mg / kg and the median duration was 9 (2-82) d. 8 cases were cured, 4 cases improved, 3 cases failed, 4 cases could not be evaluated, and the clinical effective rate was 63.2%. The type of infection, agranulocytosis and daptomycin dose have nothing to do with the efficacy, and daptomycin treatment and efficacy. Except for one case, the drug was stopped because of the increase of creatine phosphokinase. All other patients were well tolerated. Conclusion High-dose daptomycin salvage treatment of hematological infection in patients with good clinical efficacy and safety.