毛细支气管炎患儿抗菌药物使用分析

Investigation and analysis of use of antibiotics by children with bronchiolitis

目的了解毛细支气管炎患儿抗菌药物使用情况,为临床合理使用抗菌药物提供可靠依据。方法回顾性调查2010年1月-2013年5月93例毛细支气管炎住院患儿抗菌药物使用情况,结合外周血白细胞计数、中性粒细胞比例、CRP以及其他病原学检查结果,分析有无抗菌药物使用指征。结果 93例毛细支气管炎患儿入院即使用抗菌药物直至出院,其中使用一联抗菌药物48例占51.61%,二联抗菌药物45例占48.39%;一联抗菌药物使用中使用频率从高到低分别为头孢地嗪、头孢噻肟、氨苄西林/舒巴坦;二联抗菌药物使用中以阿奇霉素与β-内酰胺类抗菌药物联用所占比例最大,其次为红霉素与β-内酰胺类抗菌药物联用。结论 93例患儿中有使用抗菌药物指征者仅41例,大部分患儿无明确的抗菌药物应用指征,值得医院干预。

OBJECTIVE To investigate the status of use of antibiotics by the children with bronchiolitis so as to provide guidance for reasonable clinical use of antibiotics.METHODS A retrospective survey of use of antibiotics was conducted for 93children with bronchiolitis who were hospitalized from Jan 2010to May 2013,then the indications of use of antibiotics were analyzed with the combination of peripheral white blood cell counts,neutrophils ratio,CRP,and other etiological examination results.RESULTS The 93children with bronchiolitis used antibiotics from the admission to hospital till the discharge,among whom 48（51.61%）cases used single antibiotics and 45（48.39%）cases took two-drug therapy;the antibiotics,with the frequency of use of single antibiotic from high to low,were as follows：cefodizime,cefotaxime,and ampicillin-sulbactam;for the two-drug therapy,the children who used azithromycin combined withβ-lactams occupied the largest proportion,followed by the children who used erythromycin combined withβ-lactams.CONCLUSIONS Of the 93children,only 41have the indications for use of antibiotics,most of the children do not have clear indications,to which the hospital should take interventions.