我院PICU抗真菌药应用状况两年回顾

Using of antimycotic treatment in PICU

目的分析PICU抗真菌药应用的状况,探讨危重儿童应用抗真菌药的合理性及药物不良反应。方法回顾性分析我院2004年1月至2005年12月在PICU住院患者应用抗真菌药的临床资料。结果两年中我院PICU共收治危重患儿939例,其中应用抗真菌药的63例,占6.7%。经验性治疗32例,占50.8%,其中标本培养出阳性结果18例,占28.6%,培养菌株以白色念珠菌为主,共15例;预防性治疗31例,占49.2%。治疗总有效率为84.1%。63例中仅1例出现不良反应。结论应高度重视儿童真菌感染的高危因素,早期经验性治疗和预防性治疗尤为重要。推荐使用抗菌谱广而毒性小的抗真菌药,儿童合理应用抗真菌药是安全有效的。

Objective To describe the situation of using of antimycotie drugs in pediatric intensive care unit （PICU） and to investigate the effect and the adverse effect of antimycotie drugs on severe cases. Methods The records of patients treated with antimycotic drugs in PICU from January 2004 to December 2005 were analyzed retrospectively. Results 6.7% （63/939） of patients were treated with antimycotie drugs in PICU from January 2004 to December 2005. Twenty - nine percent of patients had confirmed mycotic infection, and Blastomyces albicans was isolated in most patients（15/18）. Fifty- one percent（32/63） of patients were treated with antimyeotic drugs by experience and 49% pa- tients（31/63） were treated for prophylaxis. Eighty - four percent of patients improved after using antimyeotic drugs, and only one patient had fever as adverse effect. Conchrsions Attention should be paid to the high risk factor of mycotic infection in children. It is effective and safe to use antimycotic by experience or prophylaxis.