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Clinical impact of a prediction score for drug-resistance in community-onset pneumonia

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Mariya Pavlova1, Anna Starshinova1, Irina Chernokhaeva1, Ekaterina Belyaeva1 and Nadezhda Sapozhnikova1
1Department of Phthisiopulmonology, St. Petersburg Scientific Research Institute of Phthisiopulmonology, St. Petersburg, Russian Federation

Objective: To determine efficiency of treatment of XDR-TB with the use of therapy containing linezolid.

Content and methods: in St-Petersburg Research Institute of Phthisiopulmonology from 2013 to 2015, 49 patients with XDR lung TB, from 18 to 60 have been treated. Linezolid was used in 24 patients with XDR-TB during the first 6 months of intensive phase of treatment in the dose - 600 mg per day intravenously, by drop infusion in combination with 5-6 anti TB drugs taking into account range of MBT drug resistance ? Studied group (group I). Control group -group II(n=25), used 5-6 anti TB drugs without linezolid.We carried out statistical analysis with the use of the program Statistica 6.0. We applied the criterion chi-square(χ2).

Results: in 6 months of therapy symptoms of intoxication were not detected among all patients both in studied and control groups. Negative results of bacterial excretion were registered in I group significantly higher than in II group: 62.5%(14) against 36.0%(9),(p>0.05). Adverse drug reactions were noted with equal frequency in both groups(29.1%(7) vs 32.0%(8). In patients who used linezolid hepatotoxic reactions occurred in 4 of 7 patients, in 3 patients ? leukopenia, neutropenia, anemia. In control group - hepatotoxic reactions(5 of 8), diarrhea(3 of 8). When symptomatic therapy was applied adverse drug reactions were resolved. Intensive phase of treatment in both groups lasted 8 months.

Conclusion: inclusion of linezolid in combined anti TB therapy resulted in cessation of bacterial excretion in 6 months in twice more frequent cases vs therapy without linezolid. Incidence of adverse drug reactions when linezolid usage was not higher than occurred for standard therapy.

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PP-PDPI. 12/09/17.

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