老年患者抗生素相关性腹泻临床特征和预防控制

Clinical Characteristics, Prevention and Control of Antibiotic- associated Diarrhea in Elderly Patients

[目的]探讨老年患者抗生素相关性腹泻（AAD）的临床特点、主要相关因素及防治措施.[方法]对2007年6月至2008年8月住院的435例老年患者临床资料进行回顾性分析.[结果]435例老年患者中发生AAD者49例,发生率11.2%,其中≥80岁者35例,占71.4%.AAD发生前使用频率较高的抗生素依次为第三代头孢菌素类（25.1%）、碳青酶烯类（19.6%）、克林霉素（14.2%）、第二代头孢菌素类（12.6%）.AAD发生与使用抗生素种类、联合用药数量、疗程、疾病严重程度、采用医疗干预措施、高龄等因素相关.[结论]合理选择和使用抗生素是预防控制老年危重患者AAD的关键.

[ObjectivelTo investigate the clinical characteristics, the main risk factors of antibiotic-associated diarrhea（AAD） in hospitalized elderly patients and their prevention and therapeutic measures. [Methodsl The clinical data of 435 elderly patients from June 2007 to August 2008 were analyzed retrospectively. [ResultslAmong all the 435 patients, AAD occurred in 49 patients which the age was over 80 years old in 35 patients（71.4%）, and the incidence of ADD was 11.2%. The antibiotics used frequently before the occurrence of AAD were third generation cephalosporin（25.1% ）, carbapenem（ 19.6%）, elindamycin（14.2 %） and second generation cephalosporin（12.6%）. The incidence of ADD was associated with the kind of antibiotics, the number of combination medication, the course of therapy, the severity of the disease, medical interventional measurement and the advanced age, etc. [Conclusion] Rational choice and usage of antibiotics is the key to prevent and control the AAD.