应用氟康唑对老年社区获得性肺炎转归的影响

Effect of Fluconazole on Transfer of Community-acquired Pneumonia in Elderly Patients

目的观察在不同阶段应用氟康唑对老年社区获得性肺炎(CAP)转归的影响。方法老年CAP患者共58例,预防性治疗组32例,痰检阳性治疗组26例;预防性治疗组在静脉使用抗菌药物5 d后,给予口服氟康唑150～200 mg,连续用药7 d,继续其他治疗;痰检阳性治疗组28例,在涂片或痰培养出白色假丝酵母菌后,加用氟康唑,首剂400 mg/d静脉滴注,次日改为200 mg静脉滴注,痰检阴性停用氟康唑。结果痰检阳性治疗组平均治愈天数、平均住院日而首次抗菌药物使用时间、氟康唑使用时间均长于预防性治疗组,差异有统计学意义(P<0.05);预防性治疗组医院感染例数2例(6.25%),痰检阳性治疗组6例(23.08%),差异有统计学意义(P<0.05)。结论对老年社区获得性肺炎在使用抗菌药物后,疑似真菌时短期使用氟康唑,可缩短住院时间及抗菌药物使用时间,减少医院感染的发生。

OBJECTIVE To observe the curative effects of treatment of fluconazole in the different stages in elderlys for community-acquired pneumonia（CAP）.METHODS A total of 58 cases were divided randomly into the clinic prediction group（n=32） and the sputum-candida positive group（n=26）.The clinic prediction group was treated per os fluconazole（150-200mg） for 7 days.The sputum-candida positive group was treated with 400mg fluconazole iv,the first day,and then 200mg iv,till the result of sputum-candida culture in vitro was negative.RESULTS The average curative days,the averge hospitalized days,the days with antibiotics,the days with fluconazole in sputum-candida positive group exceeded longer than the clinic prediction group（P0.05）.There were two cases with hospital infection in clinic prediction group（6.25%）,and 6 cases in sputum-candida positive group（23.08%）（P0.05）.CONCLUSION Treatment of fluconazole to curative the elderlys for CAP that treated by antibiotics and suspected infected with fungus can shorten the length of stay and the days of clinical application for the treatment of antibiotics,and decrease the incidence of hospital infection.