抗生素治疗老年感染性疾病与肠道菌群失调的研究

ImbaIance of intestinal fIora in elderly patients with infection disease using antibiotics

目的探讨老年抗生素治疗感染性疾病与肠道菌群的变化、影响因素及防治对策。方法因各种感染而用抗生素治疗的老年患者98例,在治疗前后进行了肠道杆/球菌比例检查和临床症状的观察,以G^-杆菌/G^+球菌<1为标准,诊断肠道菌群失调的治疗转归。结果发现与抗生素相关肠道菌群失调发生率为22.5%,与患者的病情、抗生素用药种数、剂量及疗程有关,经停用或调整抗生素、口服活菌药物等治疗均能控制病情,未发生严重并发症。结论老年尤其是重症患者肠道菌群失调的发生率较高。合理应用抗生素,监测粪便杆球菌比例及口服活菌药物等,有助于防治菌群失调。

AIMS To study the relationship of antibiotics and the change of intestinal flora, and its prevention and treatment. METHODS Elderly patients with a variety of infections (n= 98) using antibiotics were observed on the change of intestinal bacilli to cocci and clinical symptoms before and after therapy. Imbalance of intestinal flora was diagnosed as the ratio of G bacilli to G^+ cocci in stool were less than 1. At the same time, its therapy, prognosis and antibiotic use were recorded. RESULTS The incidence of imbalance of intestinal flora relating to antibiotics was 22.5%, and it was related with patient's condition, numbers of antibiotics, dosage and duration of treatment. The condition was improved by stopping or regulating antibiotics and taking oral living bacteria, and serious complications were not seen in the study. CONCLUSIONS The incidence of imbalance of intestinal flora in elderly patients is higher especially in serious cases. Rational antibiotics application, ratio monitor of bacilli to cocci in stool and oral living bacteria are helpful to its prevention and treatment.