ObjectiveTo investigate the effects of high dose tiagocycline in the treatment of lower respiratory tract infection with ineffective carbapenem treatment.

MethodsThe clinical data of 85 lower respiratory tract infection patients with ineffective carbapenem treatment were analyzed retrospectively.According to the etiology of disease before administration, the patients were divided into the empirical treatment group(26 cases) and target treatment group(59 cases), and the target treatment group was subdivided into the CRAB group(36 cases) and CRKP group(23 cases).The clinical characteristics, clinical efficiency and inflammatory markers between the empirical treatment group and target treatment group were compared, and the risk factors of clinical efficacy was analyzed.

ResultsThe clinical effective rate of high-dose tigecycline in CRAB group and CRKP group were 63.89% and 73.91%, respectively, which was significantly higher than that in empirical treatment group(30.77%)(P < 0.05 and P < 0.01).There was no statistical significance in clinical efficacy of high-dose tigecycline between CRAB group and CRKP group(P>0.05).After treatment with high-dose tigecyclne, the WBC, CRP and PCT in CRAB group and CRKP group decreased significantly(P < 0.05), while only CRP decreased significantly in empirical treatment group(P < 0.05), the differences of WBC and PCT were not statistically significant between before and after treatment(P>0.05).The results of logistic regression analysis showed that the severe disease had a significant effect on clinical efficiency(P < 0.05).

ConclusionsFor lower respiratory tract infection patients with ineffective carbapenem treatment, the combination therapy based on high-dose tigecycline can achieve good anti-infective effect on the patients, and the target treatment is more effective than empirical treatment.