口服氟康唑预防老年人使用抗生素后继发真菌感染的临床分析

A Clinical Analysis: Oral Fluconazol Prevent Fungus Infection Caused By Antibiotic In the Aged People

目的探讨口服氟康唑对于老年人使用抗生素后继发真菌感染的预防作用。方法将66例使用抗生素的老年患者随机分为治疗组及对照组,治疗组在使用抗生素同时给予口服氟康唑（100 mg/d）,对照组仅给予抗生素治疗。结果抗生素治疗14 d中发现,治疗组继发真菌感染率明显低于对照组（P〈0.05）。治疗前后及疗程中每周抽血查肝功能,治疗组有2例在停氟康唑前出现了血谷丙转氨酶轻度升高（46-65 mmol/L）,及时停服氟康唑并加保肝治疗3 d后,谷丙转氨酶均恢复正常。对照组有1例血谷丙转氨酶轻度升高（49 mmol/L）,加保肝治疗5 d后恢复正常。真菌感染主要病原菌为白色假丝酵母菌11株（73.33%）,主要感染部位为呼吸道感染6例（40%）及泌尿道感染5例（33.33%）。结论氟康唑是一种安全、有效的预防老年患者应用抗生素后继发真菌感染的药物,值得临床推广。

Objective To discuss the effects of fluconazol on preventing fungus infection caused by antibiotic in the aged people.Methods 66 gerontal patients that used antibiotics were randomly divided into treatment group and control group.Treatment group was given antibiotics,at the same time,it was given fluconazol（100 mg/d）.Thecontrol group was only given antibiotics.Results 14 days later,through the treatment of antibiotic,secondary fungus infection rate found in the treatment group was significantly lower than the control group（P〈0.05）.2 patients′ glutamate pyruvate transaminases were mildly run up to 46-65 mmol/L before stopping fluconazol in treatment group,and returned to normal while stopping fluconazol in time and after 3 days of treatments of protecting the liver functions.One patient′s glutamate pyruvate transaminase was run up to 49 mmol/L in control group,and returned to normal after 5 days of treatments of protecting the liver functions.The pathogen of fungal infection mainly was Candida albicans,about 11 cases（73.33%）.The main infection sites were respiratory tract and urinary tract,which respectively were 6 cases（40%）and 5 cases（33.33%）.Conclusion Fluconazol might be safe and effective to prevent fungal infection caused by antibiotic in the gerontal patient,which is worthy to be popularized in clinical.