美罗培南治疗小儿铜绿假单胞菌肺炎临床观察

Clinical Investigation of Meropenem in Treatment of P.aeruginosa-positive Pneumonia in Children

目的评价美罗培南治疗小儿铜绿假单胞菌肺炎的临床疗效及安全性。方法对65例痰培养证实为铜绿假单胞菌肺炎的住院患儿根据药敏结果分为治疗组(34例)和对照组(31例),治疗组给予美罗培南20mg/(kg.d),1次/8h,静脉滴注。对照组应用头孢他啶100mg/(kg.d),1次/12h,静脉滴注。疗程7～14d。所有患者均于治疗前后密切观察并记录症状、体征变化,查血、尿常规,肝、肾功能和胸片。结果治疗组:治愈30例(88.2%);好转2例(5.9%);无效2例(5.9%)。对照组:治愈14例(45.2%);好转10例(32.3%);无效7例(22.6%)。治疗组治愈率明显高于对照组(P<0.01)。两组未见严重不良反应;对照组有4例BUN和1例Scr一过性升高。结论美罗培南治疗小儿铜绿假单胞菌肺炎治愈率高,细菌耐药性低,不良反应少。对确诊铜绿假单胞菌肺炎的患儿宜首选美罗培南。

Objective To appraise the efficacy and tolerance of intravenous administration of meropenem in treatment of P. aeruginosa - positive pneumonia in children. Methods 65 inpatients with P. aeruginosa - positive pneumonia in children were divided into treatment group and control group based on results of antibiotics susceptivity. Treatment group （ n = 34） was treated with meropenem 20mg/（kg. d）, intravenously dripped 1 time/Sh, for 7 to 14d; control group （ n =31 ） was given ceftazidime 100mg/（kg. d）, intravenously dripped 1 time/12h, for 7 to 14d. Results 30 cases in treatment group were cured（88.2 % ）, better 2 cases（5.9% ）,no effect 2 cases（5.9% ）,and 14 cases in control group healed（45.2 % ） , better 10 cases （32.3%） , no effect 7 cases （22.6%）. The cure rate of treatment group was significantly higher than that of control group（ P 〈0.01 ）. No severe adverse drug reaction appeared in both groups. The concentration of BUN of 4 cases, that of serum creatinine of one patient in control group increased temporarily. Conclusion The efficacy and tolerance of intravenous meropenem are good based on the above data. Meropenem should be recommended as the first choice for P. aeruginosa - positive pneumonia in children.