急性扁桃体炎抗菌药物合理使用

Rational Use of Antibacterials in Acute Tonsillitis

目的探讨急性扁桃体炎合理的治疗方法。方法选择2005年9月—2008年4月在我院诊治的252例急性扁桃体炎患者,回顾性分析患者的临床表现及治疗方法。结果252例患者中,扁桃体化脓82例(32.5%),白细胞计数升高96例(38.1%),发热34例(13.5%)。115例白细胞或中性粒细胞计数升高患者进行抗菌药物治疗,给予头孢拉定0.5g/次,3次/d,或阿奇霉素0.5g/次(首次剂量加倍),1次/d,口服3～6d;扁桃体化脓伴发热者,根据药物过敏史,给予青霉素(360～480)万U/次,2次/d(或左氧氟沙星注射液0.2g/次,2次/d),加甲硝唑0.5g/次,1次/d,共3～6d,兼以退热、对症治疗。其余137例患者进行抗病毒治疗,给予双黄连口服液20ml/次,2次/d,共2周,并进行退热、对症治疗。252例患者均治愈。结论急性扁桃体炎可以由细菌感染引起,也可由病毒感染引起,应该结合血常规及病情决定是否使用抗菌药物,而不是一味使用抗菌药物治疗。

Objective To explore the rational treatment of acute tonsillitis.Methods A retrospective analysis was carried out on the clinical manifestations and treatments of 252 acute tonsillitis patients admitted to our hospital from September 2005 to April 2008.Results Of 252 patients,82（32.5%） presented with purulent tonsils,96（38.1%） with elevated white blood cell count,34（13.5%） with fever.One hundred fifteen patients with elevated white blood cell count or neutrophil were given such antibiotic therapy as cefradine,0.5 g every time,3 times per day,or azithromycin 0.5 g every time（double for the first time）,once a day,orally 3～6 days.Based on drug allergy history,patients with purulent tonsils accompanied by fever were given penicillin,3 600 000～4 800 000 U/time,twice a day（or levofloxacin injection,0.2 g/time,twice a day）,adding metronidazole,0.5 g every time,3～6 days,combined with pyretolysis and symptomatic treatment.The other 137 patients were given such anti-viral therapy as Shua,nghuang...更多lian oral liquid,20 ml every time,twice a day,2 weeks,combined with pyretolysis and symptomatic treatment.All patients were cured.Conclusion Acute tonsillitis may be caused by a bacterial infection or by viral.Whether to use antibacterials depends on routine blood test.