环丙沙星在PICU重症感染中的应用

Use of Ciprofloxacin children With severe infections in pediatric intensive care unit

目的 评价环丙沙星治疗小儿重症感染的有效性和安全性。方法 收集北京儿童医院儿童加强医疗病房 (PICU)重症感染患儿 2 6例 ,环丙沙星用量 10～ 2 0mg·kg-1·d-1,静脉给药 ,疗程 4～ 31d (11± 7)d。结果 用药前培养菌对环丙沙星的敏感率为 10 0 %。用药 5天后6例培养出 7株耐药菌 ,耐药菌发生率占 2 3 1% (6 / 2 6 )。其中 4例环丙沙星治疗无效改换敏感抗生素。继发霉菌感染者 4例 ,占 15 4% (4 / 2 6 ) ,2例死于霉菌败血症。本组患儿治愈 11例 ,好转出院 6例 ,无效 9例 ,总有效率为 6 5 4% (17/ 2 6 )。耐药菌株出现和霉菌感染是治疗失败的主要原因。仅 1例患儿治疗过程中出现皮疹 ,副作用发生率为 3 8% (1/ 2 6 )。

Objective To evaluate the safety and efficacy of Ciprofloxacin in the treatment of children with severe infections.Methods Date were collected from 26 patients with various infections in Pediatric Intensive Care Unit(PICU)of Beijing Children's Hospital.Ciprofloxacin was given at 10～20mg·Kg -1 ·d -1 intravenously every 12 hours for 4～31 days average (11±7) days.Results Before using Ciprofloxacin,the rate of Ciprofloxacin sensitive bacteria was 100%.After using the drug for more than five days,seven Ciprofloxacin resistant strains were cultured in 6 patients.The secondary Ciprofloxacin resistant bacteria infection rate was 23 1%(6/26) and secondary fungal infection rate was 15 4%(4/26).Two patients died of fungal septicemia.Using Ciprofloxacin,11 patients of this group were clincally cured,6 patients were improving when they were discharged from hospital,and 9 patients failed treatment mainly because of occurrence of Ciprofloxacin resistant bacterial and fungus.The total effective rate was 65 4%(17/26).Because only one patient developed rash during the treatment,the rate of side effects of Ciprofloxcin was 3 8%(1/26).Conclusion Ciprofloxacin was a relatively effective and safe drug in the treatment of pediatric severe infections.