Efficacy of Meropenem on Elderly Stroke Associated Pneumonia and Its Safety

Objective To evaluate the clinical efficacy of Meropenem on elderly stroke associated pneumonia( SAP)and its safety. Methods Sixty elderly SAP patients admitted to this hospital from March 2011 to March 2013 were given,based on their primary disease( stroke) treatment,Meropenem 0. 5 ~ 1. 0 g added with 0. 9% sodium chloride solution 100 ml,iv gtt,1 /8 h,which was adjusted according to patients' creatinine clearance,averaging( 12. 5 ± 2. 0) d. Patients' disease condition and temperature changes were recorded,sputum cultured,laboratory test results and chest CT compared between pre-and post-treatments,adverse reactions observed. Results Ten patients died during treatment,50 had stable condition. Before taking Meropenem,all patients had different degrees of fever,in the 50 survivors 19 had moderate fever,31 had high,which reduced gradually to normal after Meropenem,averaging for( 4. 5 ± 1. 0) d; The temperature of the dead did not reduce after Meropenem. The levels of peripheral blood cells( WBC),neutrophil fraction,serum C-reactive protein in the survivors were lower after treatment than before( P 0. 05); Arterial partial pressure of oxygen and oxygenation index higher( P 0. 05). There was no significant difference in levels of alanine aminotransferase,aspartate aminotransferase,urea nitrogen,creatinine between pre-and post-treatments( P 0. 05). Post-treatment chest CT of the survivors showed that pulmonary inflammatory exudation lesions were absorbed and improved as compared with those of pre-treatment. A total of 75 stains of pathogenic bacteria were cultured out,including 45 stains of G-bacteria( 60%),15 G+( 20%),15 fungi( 20%). The clearance of 60 G-and G+bacteria was 86. 7%( 52 /60). Forty-eight patients were cured,2 had remarkable effect,10 had no,the total effective rate was 83. 4%. In the survivors,3 pad torso rash; In the dead,5 had central nervous system symptoms such as muscle spasms,epilepsy. Conclusion Meropenem,being of good therapeutic effect on elderly SAP with fewer adverse reactions,is worthy of clinical application.