The clinical efficacy of prepenem for treatment for lower respiratory tract infection of cranial neurosurgical patients after tracheotomy

Objective To investigate the clinical curative effect of Prepenem for pathogen from cranial neu-rosurgieal patients with lower respiratory tract infection after traeheotomy and to provide basis for treatment of such pa-tients. Methods Thirty-two cranial neurosurgical patients with lower respiratory tract infection after tracheotomy were enrolled in the study with original empiric therapy with Prepenem. And the pathogenic bacteria in sputum from patients with lower respiratory tract infection after traeheotomy were stricdy identified and analyzed by automatic mi-croorganism analyzers. The clinical efficacy of Prepenem was identified after treatment. Results The straim of bacte-rial species(48) and funni(5) from 32 specimens were isolated. 15 strains were infected by one kind of bacteria and 38 strains were infected by two kinds of bacteria. Among the pathogen, gram-negative bacilli were about 64. 1% and Klebsiela pneumoniae (18. 8%)was the most predominant, gram-positive coccobacteria were about 26. 4% and Staph-ylococcus aureus(13.2%)was the most predominant,funni were about 9.4% and C. albicans (5.7%)was the most predominant. The drug sensitivity test showed that the ratio of drug resistance of bacteria isolated from sputum was high,but gram-negative bacilli were highly sensitive to imipenem. Staphylococcus aurens was sensitive to Nitrofuran-toin and Rifampicin. Satisfied clinical curative effect was shown by the de-escalation therapy for all patients. Conclu-sions Gram-negative bacili in cranial neurosurgical patients with lower respiratory tract infection after tracheotomy are the main pathogenic bacteria from lower respiratory tract infection, and Staphylococcus aureus are the main gram-positive cocci. So the drug sensitivity test of sputum should be done more often and antibiotics must be selected ac-cording to the drug sensitivity test. In general, this kind of infection can be controlled by prepenem effectively. Key words: Tracheotomy;  Respivatory tract infections ; Imipenem-cilastatin sodium