重新认识氯霉素对小儿恙虫病的临床作用

Rethinking of chloramphenicol on the clinical effect of scrub typhus

目的重新认识氯霉素对小儿恙虫病的临床作用。方法对近5年收治的153例小儿恙虫病分成不伴多器官功能损害组和伴多器官功能损害组,应用氯霉素和阿奇霉素治疗,进行临床分析。结果不伴多器官功能损害组,氯霉素和阿奇霉素疗效无差异;伴多器官功能损害组,氯霉素较阿奇霉素效果显著。差异有统计学意义。结论轻症病例,可首选大环内酯类抗生素,如阿奇霉素治疗,如患儿并多器官功能损害,则应果断应用氯霉素以达到迅速起效,以免延误治疗,导致病情加重或出现更多的并发症,错过治疗机会。传统药物氯霉素在小儿恙虫病的治疗中仍处在不可被替代的地位。

Objective To recognize chloromycetin on clinical effect of pediatric clinical scrub typhus. Methods The report included the clinical analysis for 153 cases of scrub typhus, and observed the efficacy of azithromycin and chloramphenicol. According to whether complicated with multiple impaired organ function, they are separate into two groups. The experimental group is complicated with multiple impaired organ function. The control group had no multiple impaired organ function. Results Compared with the efficacy of azithromycin and chloramphenicol, the control group had no difference, but the experimental group had a significant difference. The effect of chloramphenicol is better than azithromycin. Conclusions Macrolide antibiotics such as azithromycin treatment should be the first choice for mild cases . As to the cases with multiple organ dysfunction, should be accepted the decisive application of chloramphenicol in order to achieve the rapid onset of action, so as not to delay treatment, resulting in severe or more complications, treatment for miss. Traditional drug chloramphenicol in the treatment of scrub typhus for children still had a irreplaceable status.