■抗生素经常引起肝功能异常。Omadacycline是一种新型的氨甲基环素抗生素,对革兰氏阳性和革兰氏阴性需氧显示出有效的活性,厌氧,和非典型(包括嗜肺军团菌)细菌。值得注意的是,奥马环素在大多数肝功能损害患者中可以耐受。然而,关于奥马环素在经历肝功能障碍后的肺炎军团菌肺炎患者中应用的证据很少。
■目前的研究报告了6例肺炎军团菌患者在经历肝功能障碍后接受omadacycline作为后续抗生素。
■这6例因肺炎入院并接受抗生素治疗,包括哌拉西林他唑巴坦,亚胺培南,美罗培南,和莫西沙星.在接受这些抗生素后,注意到肝酶增加。尽管给予了保肝治疗(如异甘草酸镁和谷胱甘肽),肝功能仍然异常。根据宏基因组下一代测序,这些患者被诊断为嗜肺军团菌肺炎.考虑到肝功能异常,抗生素治疗改用含有奥马环素的抗生素治疗.之后,肝功能得到改善,感染得到改善。最终,所有出院的病人,包括2例临床症状完全改善的患者和4例临床症状部分改善的患者。
■这项研究强调了在嗜肺军团菌肺炎患者经历肝功能异常后改用奥马环素的成功治疗。这项研究表明,奥马环素可以作为肺炎军团菌肺炎患者的可选抗生素,尤其是发生肝功能障碍时。然而,需要更多的临床研究来验证我们的发现.
UNASSIGNED: Antibiotics frequently induce abnormal liver function. Omadacycline is a novel aminomethylcycline antibiotic, which shows potent activity against Gram-positive and Gram-negative aerobic, anaerobic, and atypical (including Legionella pneumophila) bacteria. Of note, omadacycline is tolerable in most patients with liver impairment. However, evidence regarding the application of omadacycline in patients with Legionella pneumophila
pneumonia after experiencing liver dysfunction is scarce.
UNASSIGNED: The current study reported 6 cases of patients with Legionella pneumophila
pneumonia receiving omadacycline as subsequent antibiotics after experiencing liver dysfunction.
UNASSIGNED: These 6 cases were admitted to the hospital for
pneumonia and received antibiotic therapy, including piperacillin-tazobactam, imipenem, meropenem, and moxifloxacin. After receiving these antibiotics, increased liver enzymes were noted. Although hepatoprotective therapy (such as magnesium isoglycyrrhizinate and glutathione) was given, the liver function was still abnormal. According to metagenomic next-generation sequencing, these patients were diagnosed with Legionella pneumophila
pneumonia. Considering the abnormal liver function, the antibiotic therapy was switched to omadacycline-containing antibiotic therapy. After that, liver function was improved, and the infection was ameliorated. Ultimately, all patients discharged from the hospital, including 2 patients who achieved complete clinical symptomatic improvement and 4 patients who achieved partial clinical symptomatic improvement.
UNASSIGNED: This study emphasizes the successful treatment of switching to omadacycline after experiencing abnormal liver function in patients with Legionella pneumophila
pneumonia. This study suggests that omadacycline may serve as an optional antibiotic for patients with Legionella pneumophila pneumonia, especially when occurring liver dysfunction. However, more clinical studies are required to validate our findings.