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В.П. Яковлев Институт хирургии им. А.В. Вишневского РАМН, Москва
В начало...
(Окончание)
Переносимость цефепима хорошая. Побочные реакции его при применении по частоте и выраженности были близки к наблюдаемым при использовании цефалоспоринов III поколения. При анализе побочных эффектов, наблюдаемых при лечении цефепимом или цефтазидимом соответственно 2023 и 1456 больных, было показано, что их частота составляет 20,3 и 23,1%. Нежелательные эффекты со стороны сердечно-сосудистой системы встречались в 1 и 1,1%, желудочно-кишечного тракта (диарея, тошнота, рвота, запоры) - в 6,3 и 8,2%, нервной системы - в 3 и 2,7%, дыхательных путей - в 0,8 и 1,5%, кожи (кожный зуд, сыпь) - в 3 и 3,3%, урогенитальной системы - в 0,9 и 1,2%. Прекращение лечения из-за побочных эффектов (чаще всего кожная сыпь) потребовалось у 36 и 41 больных [42].
В ряде исследований отмечается более низкая стоимость лечения больных с инфекциями цефепимом по сравнению с другими цефалоспоринами [43, 44].
Таким образом, цефалоспориновый антибиотик IV поколения - цефепим представляет собой препарат выбора при эмпирической терапии тяжелых госпитальных инфекций - госпитальной пневмонии, интраабдоминальных инфекций (в комбинации с метронидазолом), гинекологических инфекций, сепсиса, вызванного грамотрицательными бактериями, а также инфекций у больных с нейтропенией. Цефепиму может быть отдано предпочтение при лечении тяжелых инфекций вместо близких по активности препаратов, но с более высокой стоимостью лечения.
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