阿米卡星对ICU碳青霉烯耐药菌治疗的应用价值分析

Analysis of the Application Value of Amikacin in the Treatment of Carbapenem-Resistant Organisms in ICU

摘要: 目的：探究阿米卡星对ICU碳青霉烯耐药菌(CRO)所致感染的临床应用价值。方法：收集我院2021年~2024年CRO检出数据，对ICU检出者统计总医疗费用、药品费用、抗生素费用，对其中考虑为CRO致病菌的患者额外统计治疗方案、生化指标及治疗效果，并对所获得的数据分组比较。结果：ICU阿米卡星对CRO的耐药率为38.42%与全院基本一致；含阿米卡星的治疗方案可降低患者体温1.26 ± 0.81℃、白细胞计数3.42 ± 4.89 × 10⁹/L，与其他方案相比差异具有统计学意义(P = 0.021, P = 0.026)；对CRO的治疗有效率为81.82%，高于其他方案组的25.00% (P = 0.001)；总医疗费用较其他方案低28561.76元(P = 0.342)，抗生素费用低7162.38元(P = 0.005)，并且所有患者均未出现肌酐水平异常升高。结论：阿米卡星对CRO治疗效果好，安全性较高，能有效降低抗生素费用，适用于ICU CRO感染患者的治疗。

Abstract: Objective: To explore the clinical application value of Amikacin in the treatment of infections caused by Carbapenem-resistant Organisms (CRO) in ICU. Method: Detected data of CRO from 2021 to 2024 are collected by HIS, the medical expenses, drug cost and antibiotic cost are collected for CRO detected-patients in ICU. For patients that the CRO was considered as pathogens, the treatments, biochemical parameters and therapeutic effects are collected additionally. The obtained data were grouped and compared. Results: The resistance rate of Amikacin to CRO in ICU is 38.42% consistent with the entire hospital. The Amikacin group can reduce the patient’s temperature 1.26 ± 0.81˚C and WBC 3.42 ± 4.89 × 10⁹/L with statistically significant differences compared to other regimens respectively (P = 0.021, P = 0.026); The effective rate of Amikacin group for infection caused by CRO is 81.82%, superior than the 25.00% of other regimens (P = 0.001); Compared with the other regimens, the Amikacin group reduced the medical expenses ¥28561.76 (P = 0.342), the antibiotics cost ¥7162.38 (P = 0.005). Significant changes of creatinine levels are not observed in patients of the Amikacin group. Conclusion: Amikacin has good efficacy and high safety in the treatment of CRO, reducing antibiotic costs and suppressing the growth of medical expenses. It is suitable for the treatment of patients with CRO infection in ICU.