抗生素序贯疗法治疗婴幼儿重症肺炎疗效观察

Effect of sequential antibiotic therapy on infants with severe pneumonia

目的 探讨抗生素序贯疗法治疗婴幼儿重症细菌性肺炎的效果。方法 123例重症肺炎患儿分为2组，对照组在第2级选用抗菌谱宽、耐酶的抗生素，应用到患儿痊愈；观察组采用抗生素序贯疗法，首先在第2级选择抗生素，在重症肺炎的并发症控制后1～3d，再在第1级中选择抗菌谱窄或不耐酶抗生素，直至痊愈。结果 观察组抗生素相关性腹泻发生率（8．20％）明显低于对照组（25．81％，P〈0．01）；观察组医疗费（2467±150）元较对照组（2865±120）元显著降低（P〈0．01）；2组并发症控制时间、肺部啰音消失时间及平均住院时间比较无显著差异（P〉0．05）。结论 抗生素序贯疗法是治疗婴幼儿重症肺炎的有效方法，既可降低二重感染的发生机会，又能节约医疗费用。

Objective To observe the effect of sequential antibiotic therapy on infants with severe pneumonia. Methods One hundred and twenty-three patients with severe pneumonia were divied into two groups,the second level antibiotics were used in control group untill children cured;sequential antibiotic therapy was adopted in observation group：the second level antibiotics were used first of all, after the complications were controled for 1 -3 days, the first level antibiotics were used until children cured. Results The incidence of antibiotic-associated diarrhea in observation group（8.20% ） was lower than this in control group（25.81% ,P 〈0.01 ）. The average medical costs of therapy group（2467 ± 150 yuan） was decreased than that of con- trol group（2865 ± 120 yuan,P 〈 0.01 ）. There was no significant difference between the two groups in the duration of complications and pulmonary rales and the average length in hospital（P〉0.05）. Conclusion Sequential antibiotic therapy is an effective way on infants with severe pneumonia and can decrease dual infection and medical costs.