抗生素降阶梯治疗在糖尿病重症肺炎患者中的应用研究

Effects of de-escalation of antibiotic on diabetics with severe pneumonia

目的分析抗生素降阶梯疗法在糖尿病重症肺炎患者中的临床应用效果。方法 30例糖尿病重症肺炎患者,随机分成抗生素降阶梯治疗组(A组18例)和常规升级组(B组12例),比较两组患者病死率、肺脏CT感染灶吸收率、抗生素使用时间、平均住院日、并发症控制时间及真菌定植发生率。结果 A组患者抗生素使用疗程、平均住院日较B组短(P<0.05),抗生素使用15d后病灶吸收率较B组高(P<0.05),病死率、真菌定植发生率较B组低(P<0.05)。结论抗生素降阶梯疗法治疗糖尿病重症肺炎患者具有控制感染迅速、病死率低、住院时间缩短等优点。

【Objective】To define effects of de-escalation of the antibiotic on diabetes with severe pneumonia. 【Methods】Thirty diabetics with severe pneumonia were divided into two groups randomly： group A （n=18） and B （n=12）. Patients in group A received de-escalation of the antibiotic treatment and group B received conventional treatment. The two groups were compared by the use of antibiotics treatment, mortality and the incidence of fungal colonization, and so on.【Results】Length of antibiotic treatment and patient stay in group A was shorter than group B （P〈0.05）, absorption of focus of infection was sooner than group B （P〈0.05）, and mortality was significantly lower than group B （P〈0.05）. Fungal colonization rate in group B was higher than the group A （P〈0.05）.【Conclusion】 Choice of de-escalation of the antibiotic could improve significantly the prognosis of diabetics with severe pneu- monia.