Efficacy of high-dose ambroxol combined with imipenem in treatment of elderly patients with severe pneumonia treated by mechanical ventilation
YAN Bin1, ZHAO Guifeng1, ZHANG Mei2
1. Department of Intensive Care Unit, 2. Department of Gynecology and Obstetrics, Characteristics Medical Center of PLA Rocket Force, Beijing 100088, China
Abstract：Objective To investigate the efficacy and safety of high-dose ambroxol combined with imipenem in the treatment of elderly patients with severe pneumonia treated by mechanical ventilation. Methods A total of 86 elderly (≥80 years old) patients with severe pneumonia admitted to ICU of Characteristics Medical Center of PLA Rocket Force from June 2019 to June 2023 were divided into two groups by random number table method, they were divided into two groups. The control group included 40 patients who received conventional-dose ambroxol combined with imipenem treatment, while the study group included 46 patients who received high-dose ambroxol [15 mg/(kg·d)] combined with imipenem treatment. The efficacy of the two groups was compared after treatment, including lung imaging, duration of mechanical ventilation, length of ICU stay. APACHE Ⅱ, SOFA, CPIS, changes in inflammatory factors and adverse reactions. Results Compared with the control group, the duration of mechanical ventilation of the study group was shorter[(8.15±1.31)d vs. (7.13±1.53)d, P<0.05],disappearance time of shadow on chest radiograph was faster[(7.80±1.02)d vs. (6.61±0.97)d, P<0.05]. The duration of ICU stay was shorter [(16.25±1.78)d vs. (14.37±2.15)d, P<0.05], and the lesion absorption rate was higher[(65.95±7.73)% vs. (78.96±9.11)%, P<0.05]. After treatment, APACHE Ⅱ [(7.17±1.07) vs. (8.25±1.12), P<0.05], SOFA [(3.15±0.51) vs. (4.21±0.96), P<0.05], CPIS[(3.18±0.89) vs. (3.80±0.75), P<0.05], PCT[(0.16±0.07) μg/L vs. (0.25±0.12)μg/L, P<0.05], CRP[(5.15±3.11)mg/L vs. (8.51±2.96)mg/L, P<0.05], IL-6 [(15.28±9.89) ng/L vs. (25.20±1.75) ng/L, P<0.05]of the study group decreased faster. There was no significant difference in the incidence of adverse reactions between the two groups during the observation period (P>0.05). Conclusions High-dose ambroxol combined with imipenem in the treatment of elderly patients with severe pneumonia treated by mechanical ventilation can shorten the duration of mechanical ventilation and ICU stay, and the safety is good.
闫斌, 赵贵锋, 张梅. 大剂量氨溴索联合亚胺培南治疗机械通气高龄重症肺炎患者的疗效[J]. 武警医学, 2024, 35(4): 335-338.
YAN Bin, ZHAO Guifeng, ZHANG Mei. Efficacy of high-dose ambroxol combined with imipenem in treatment of elderly patients with severe pneumonia treated by mechanical ventilation. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(4): 335-338.
Hu M, Zhu Z, Wu Y, et al. Exploring the potential of hydrophilic matrix combined with insoluble film coating: preparation and evaluation of ambroxol hydrochloride extended release tablets[J]. AAPS Pharm Sci Tech, 2020, 21(3):93.
[4]
Torres A, Chalmers J D, Dela Cruz C S, et al. Challenges in severe community-acquired pneumonia: a point-of-view review[J]. Intensive Care Med, 2019, 45(2):159-171.
Girón R M, Ibáñez A, Gómez-Punter R M, et al. New evidence in severe pneumonia: imipenem/cilastatin/relebactam[J]. Rev Esp Quimioter,2022,35 (Suppl 1):46-49.
[12]
Cataldi M, Sblendorio V, Leo A, et al. Biofilm-dependent airway infections: a role for ambroxol?[J]. Pulm Pharmacol Ther, 2014,28(2):98-108.
Wang Y, Li X, Wang D, et al. In vitro interactions of ambroxol hydrochloride or amlodipine in combination with antibacterial agents against carbapenem-resistant acinetobacter baumannii[J]. Lett Appl Microbiol,2020,70 (3):189-195.
Hu M, Zhu Z, Wu Y, et al. Exploring the potential of hydrophilic matrix combined with insoluble film coating: preparation and evaluation of ambroxol hydrochloride extended release tablets[J]. AAPS Pharm Sci Tech, 2020, 21(3):93.
Wang Y, Li X, Wang D, et al. In vitro interactions of ambroxol hydrochloride or amlodipine in combination with antibacterial agents against carbapenem-resistant acinetobacter baumannii[J]. Lett Appl Microbiol,2020,70 (3):189-195.
2024, Vol. 35 
