Clinical evaluation of amikacin combined with biapenem in the treatment of severe pneumonia

Zhang Bei; Zeng Guixin; Liu Shanshan

doi:10.3969/j.issn.1672-8157.2025.06.005

Abstract：Objective To evaluate the clinical efficacy of amikacin combined with biapenem in the treatment of severe pneu-monia.Methods A total of 92 patients with severe pneumonia admitted to Nanyang Central Hospital between January 2022 and December 2024 were enrolled and randomly divided into a control group and an experimental group according to the random number table method,with 46 patients in each group who met the clinical observation criteria.The control group received biapenem,and the experimental group received amikacin combined with biapenem.Both groups were continuous treated for 14 days.The clinical effi-cacy,serum indicators,stress hormone indicators,pulmonary function indicators,and the incidence of adverse reactions were com-pared between the two groups.Results The total effective rate was higher in the experimental group than that in the control group(91.30%(42/46)vs 73.91%(34/46),χ2=4.842,P=0.028).After treatment,the levels of pulmonary surfactant protein D,procalcitonin,C-reactive protein,high mobility group protein B1,soluble myeloid cell trigger receptor 1,and microRNA-233 in the experimental group((105.90±15.76)ng·mL-1,(3.15±0.87)μg·L-1,(24.63±3.11)mg·L-1,(119.25±16.23)μg·L-1,(42.45±4.22)ng·L-1,(1.18±0.17),respectively)were all lower than those in the control group((177.65±21.54)ng·mL-1,(6.93±1.25)μg·L-1,(40.57±5.53)mg·L-1,(140.32±13.62)μg·L-1,(50.90±6.01)ng·L-1,(1.53±0.16),respectively)(t=18.237,16.834,17.040,6.745,7.804,10.168,all P<0.05);the levels of norepinephrine and cortisol in the experimental group((27.45±2.18)ng·mL-1,(90.15±10.56)ng·mL-1,respectively)were both lower than those in the control group((45.02±4.23)ng·mL-1,(174.13±18.67)ng·mL-1,respectively)(t=25.042,20.554,both P<0.05);the levels of forced expiratory volume in the first second,forced vital capacity,and inspiratory capacity in the experimen-tal group((2.12±0.33)L,(3.22±0.40)L,(2.51±0.45)L,respectively)were all higher than those in the control group((1.89±0.22)L,(2.99±0.46)L,(2.14±0.41)L,respectively)(t=3.933,2.559,4.122,all P<0.05),while the functional residual capacity((1.89±0.16)L)was lower than that in the control group((2.78±0.56)L)(t=10.364,P<0.05).There was no statistically significant dif-ference in the incidence of adverse reactions between the two groups(10.87%(5/46)vs 13.04%(6/46),χ2=0.103,P=0.748).Conclusion Amikacin combined with biapenem in the treatment of severe pneumonia can suppress the inflammatory cascade,modulate stress response,improve pulmonary function,enhance clinical efficacy,and has good safety.