82例慢性阻塞性肺疾病患者抗生素相关性腹泻的临床分析

Antibiotic-Associated Diarrhea in COPD Patients:Analysis of 82 Cases

目的:探讨慢性阻塞性肺疾病患者抗生素相关性腹泻(AAD)的发病率、潜伏期、临床特点及防治措施。方法:对我院呼吸内科慢性阻塞性肺疾病968例应用抗生素的住院患者,自抗生素应用之日起进行为期30d的前瞻性追踪观察。结果:AAD发病率为8.47%(82/968),潜伏期为(8.35±5.19)d;AAD患者以单纯性腹泻最多,占84.15%(69/82);较易引起AAD的抗生素为头孢菌素(42.68%)、青霉素类(23.17%);抗生素使用时间≥7d,联合使用抗生素3种及以上,AAD发病率明显增高;82例AAD患者经停用或换用抗生素,服用微生态制剂、甲硝唑或万古霉素等处理,痊愈71例(86.59%),好转10例(12.20%),无效1例(1.21%)。结论:AAD是一种常见的抗生素治疗的并发症,合理使用抗生素是预防发生AAD的有效措施。

OBJECTIVE： To probe into the incidence, latency, clinical features and prevention of the antibiotic - associated diarrhea （AAD）. METHODS： 968 patients with chronic obstructive pulmonary diseases （COPD） treated with antibiotics in the respiratory department of our hospital were prospectively followed for 30 days immediately after administration of an- tibiotics. RESULTS： The incidence of AAD was 8.47% （82/968） and the latency of AAD was （8.35± 5.19） days. 84.15% （69/82）of the AAD cases manifested as simple diarrhea. The AAD was chiefly induced by eephalosporins （42.68%） and penicillins （23.17%）. The incidence of AAD increased markedly if the length of the antibiotic treatment was ≥7 days or if at least 3 kinds of the antibiotics were used concomitantly. After discontinuation or alteration of the antibiotics or administration of microbial ecological agents, metronidazole or vancomycin, 71（86.59% ） of the total 82 AAD cases were cured, 10（12.20% ） improved and 1 （1.21%） showed no response. CONCLUSION： AAD is a frequent complication of antibiotic therapy. A powerful measure to prevent AAD is rational use of antibiotics.