Effect analysis of different doses of imipenem/cilastatin sodium in the treatment of severe pneumonia

doi:10.3877/cma.j.issn.1674-6902.2024.01.014

Abstract

Abstract:

Objective

To analyze the efficacy of different doses of imipenem/cilastatin sodium in the treatment of severe pneumonia.

Methods

A total of 58 patients with severe pneumonia admitted to the hospital from July 2021 to August 2023 were selected and divided into a control group (27 cases) and an observation group (31 cases) according to different treatment methods. Both groups received basic treatment. The control group received low dose (1.0 g) of imipenem and cilastatin sodium, while the observation group received high dose (2.0 g) of imipenem and cilastatin sodium. Both groups were treated for 7 days. Lung function, blood gas indexes, clinical efficacy, serological indexes, pathogenic bacteria clearance and adverse reactions were compared in two groups.

Results

Serum indicators, IL-8 of observation and control groups before treatment(0.47±0.06) vs. (0.46±0.05), after treatment (0.21±0.03) vs. (0.28±0.04)ng/ml(P<0.05); sICAM-1 before treatment(33.57±4.96) vs. (32.48±4.32), after treatment(8.25±2.08) vs. (14.19±3.27)ng/L(P<0.05). Arterial blood gas parameters, PaCO₂ of observation and control groups, before treatment(83.57±7.22) vs. (82.43±7.68)mmHg, after treatment(56.38±5.07) vs. (67.23±6.15)mmHg(P<0.05); PaO₂ before treatment(54.83±6.79) vs. (53.40±6.51)mmHg, after treatment (91.35±9.81) vs. (77.36±8.42)mmHg(P<0.05); SaO₂ before treatment(85.26±6.64) vs. (86.77±6.24)%, after treatment(95.63±8.97) vs. (90.82±7.39)%(P<0.05). After treatment, maximum mid-expiratory flow (MMF), forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC) levels in 2 groups were increased (P<0.05), and those in observation group were higher [FVC(2.99±0.48)L, FEV₁(2.18±0.35)%, MMF(1.59±0.31)L/s (P<0.05)].

Conclusion

Compared with low dose imipenem cilastatin sodium, high dose imipenem cilastatin sodium is effective in the treatment of severe pneumonia, can improve lung function and blood gas indexes, reduce inflammatory response, regulate serum sICAM-1 and CD40L levels, and increase the clearance rate of pathogenic bacteria, and is safe and reliable.

Key words: Different dose, Imipenem cilastatin sodium, Severe pneumonia, Curative effect, Adverse reaction

Lu Zhou, Guiliang Qian, Jian Huang, Yongli Xin. Effect analysis of different doses of imipenem/cilastatin sodium in the treatment of severe pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(01): 73-77.

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References 30

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组　别	例数	IL-8(ng/ml)		CD40L(ng/L)		sICAM-1(ng/L)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	31	0.47±0.06	0.21±0.03^a	3.53±0.58	1.65±0.31^a	33.57±4.69	8.25±2.08^a
对照组	27	0.46±0.05	0.28±0.04^a	3.75±0.52	2.24±0.43^a	32.48±4.32	14.19±3.27^a
t值		0.892	9.849	1.971	7.836	1.194	10.816
P值		0.375	0.000	0.052	0.000	0.236	0.000

组　别	例数	IL-8(ng/ml)		CD40L(ng/L)		sICAM-1(ng/L)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	31	0.47±0.06	0.21±0.03^a	3.53±0.58	1.65±0.31^a	33.57±4.69	8.25±2.08^a
对照组	27	0.46±0.05	0.28±0.04^a	3.75±0.52	2.24±0.43^a	32.48±4.32	14.19±3.27^a
t值		0.892	9.849	1.971	7.836	1.194	10.816
P值		0.375	0.000	0.052	0.000	0.236	0.000

组　别	例数	PaCO₂(mmHg)		PaO₂(mmHg)		SaO₂(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	31	83.57±7.22	56.38±5.07^a	54.83±6.79	91.35±9.81^a	85.26±6.69	95.63±8.97^a
对照组	27	82.43±7.68	67.23±6.15^a	53.40±6.51	77.36±8.42^a	86.77±6.24	90.82±7.39^a
t值		0.757	9.559	1.062	7.545	1.153	2.883
P值		0.451	0.000	0.291	0.000	0.252	0.005

组　别	例数	PaCO₂(mmHg)		PaO₂(mmHg)		SaO₂(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	31	83.57±7.22	56.38±5.07^a	54.83±6.79	91.35±9.81^a	85.26±6.69	95.63±8.97^a
对照组	27	82.43±7.68	67.23±6.15^a	53.40±6.51	77.36±8.42^a	86.77±6.24	90.82±7.39^a
t值		0.757	9.559	1.062	7.545	1.153	2.883
P值		0.451	0.000	0.291	0.000	0.252	0.005

组　别	例数	FVC(L)		FEV₁(%)		MMF(L/s)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	31	1.79±0.32	2.99±0.48^a	1.12±0.18	2.18±0.35^a	0.33±0.04	1.59±0.31^a
对照组	27	1.72±0.29	2.47±0.40^a	1.19±0.17	1.63±0.26^a	0.34±0.05	0.96±0.21^a
t值		1.131	5.799	1.975	8.770	1.097	11.678
P值		0.261	0.000	0.051	0.000	0.275	0.000

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