头孢三嗪噻肟(Ceftriaxone)治疗新生儿败血症

Treatment of Septicemia with Rocephin (Ceftriaxone) in Neonates

用瑞士Roche药厂生产的头孢三嗪噻肟(ceftriaxone)治疗新生儿败血症,剂量为40-80mg/kg/d溶于10%葡萄糖中静脉点滴用药5—17天,13例病人单用头孢三嗪噻肟治疗,其余2例先用氨苄基青霉素加新型青霉素Ⅱ10天有效,再用头孢三嗪噻肟治愈.我们将头孢三嗪噻肟治疗金黄色葡萄球菌4例和表皮葡萄球菌2例新生儿败血症的结果与氨基等苄霉素加新型青霉素Ⅱ治疗金黄色葡萄球菌12例和表皮葡萄球菌9例新生儿败血症结果做一比较,从用药至血培养阴性时间分别为7.5±0.68天和11.38±2.22天,虽然因头孢三嗪噻肟治疗例数减少,使两者差别尚未达到统计显著的程度,但是从其趋势似可看出头孢三嗪噻肟疗效为优(0.1>P>0.05).药物不良反应不大,主要为胃肠道反应和霉菌二重感染.食欲减退(2例/15例),腹泻(2例/15例),暂时性血清谷丙转氨酶轻度升高(3例/8例)均于停药后恢复正常,霉菌性口炎,肠炎(6例/15例),经抗霉菌治疗得到控制.结论为头孢三嗪噻肟是一广谱杀菌抗菌素,它可安全有效地应用于新生儿败血症的治疗.

A Swiss Roche antibiot-ic Rocephin a used in the treatment of 15neonates with septicemia. The dose ofRocephin used in this series or cases was40-80mg per kilo bodyweight daily, whichwas dissolved in 10% glucose solution in-fused intravenously. The duration oftreatment depends on the severity of infec-tion, its clinical course and bacteriologicalvariations, namely, 5-17 days (mean 10days). 13 cases of septicemia were cured bythe use of Rocephin only. In another 2cases after using the Ampicillin andOxacillin, the positive blood culturestranstormed to negative ones and then thepatients were treated with Rocephin in-stead. In comparison with the Rocephin effi-ciency in 4 staphlococcus aureus and 2staphylococcus epidermidis septicemicneonates, the combined Ampicillin-Oxacillin therapy was used in 12 stap-hylococcus aureus and 9 staphylo-coccus epidermidis septicemic patients. Theintravenous infusion dose of Ampi-cillin-Oxacillin in mentioned above twogroups were 150 mg/ kg/ day ±150mg / kg/ day and 140 mg/ kg/ day ±140mg / kg / day respectively. The durations from Rocephin use tosterile culture in 6 cases (7.5± 0.68) shorterthan the ones with Ampicillin+Oxacillin in21 cases (11.38±2.22). So that we mightsay the Rocephin was more efficient incontrol of staphylococcus aureus andstaphylococcus epidermidis septicemiathan combined Ampicillin and Oxacillin,though there was no statistical significancedue to the limita-tion of cases (0.1> P >0.05). Gastrointestinal disturbances, such asloss of appetite (2 / 15), diarrhea (2 / 15)and transient rise of serum transaminase(3 / 8) were the chief side effects observedin our patients. All of these disapeared rap-idly and completely after withdrawing thetreatment. Dual infection is an other im-portant problem which requires specialemphasis. For instance, fungus infectionhas been found in 6 / 15 of our series andantifungus therapy has been applied withfairly good results. Therefore, it may be concluded thatRocephin is a broadspectrum bacterici-dalantibiotic, which can be safely andeffeciently used in neonates with se-pticemia.