阿莫西林/克拉维酸钾、头孢他啶单用与联用治疗新生儿肺炎的疗效及其对肠道微生态的影响

Effect of Amoxicillin / Clavulanate Potassium and Ceftazidime in Neonatal Pneumonia and the Affection to Intestinal Microecology

目的:探讨并比较阿莫西林/克拉维酸钾、头孢他啶单用与联用治疗新生儿肺炎的疗效及对肠道微生态的影响。方法:将81例新生儿肺炎患儿随机分为阿莫西林/克拉维酸钾组、头孢他啶组、联合用药组各27例,另选同期在我院出生的健康新生儿27例作为对照组。阿莫西林/克拉维酸钾组给予静脉注射阿莫西林/克拉维酸钾,头孢他啶组给予静脉注射头孢他啶,联合用药组给予静脉注射阿莫西林/克拉维酸钾和头孢他啶,均按说明书用药治疗1周。结果:三组患儿的治愈率、治愈时间比较差异均无统计学意义(P均>0.05);三组患儿使用抗生素治疗1周后,肠道乳酸杆菌、双歧杆菌、肠球菌、真杆菌4种益生菌数量均少于对照组(P均<0.01),肠杆菌(腐败菌)数量均多于对照组(P均<0.01);联合用药组治疗1周后4种益生菌的数量均少于阿莫西林/克拉维酸钾组和头孢他啶组(P均<0.01)。结论:阿莫西林/克拉维酸钾、头孢他啶单用与联用治疗新生儿肺炎的效果相当,但联合用药对患儿肠道正常微生态的影响更大,因此,临床在选择抗生素联用方案时应慎重。

Objective： To explore the clinical effect and adverse reactions of amoxicillin/clavulanate potassium and ceftazidime on neonatal pneumonia. Methods： We randomly divided 81 neonates diagnosed as neonatal pneumonia into amoxicillin / clavulanate potassium group 27 cases,ceftazidime group 27 cases and drug combination group 27 cases. Additionally we choose 27 healthy neonates born in our hospital as control group. The amoxicillin / clavulanate potassium group was treated with amoxicillin / clavulanate potassium intravenously,the ceftazidime group was treated with ceftazidime intravenously and the drug combination group was treated with amoxicillin / clavulanate potassium combined with ceftazidime intravenously. Results： There were no statistical differences in cure rate and median of cure duration（ P 0. 05）. After one week＇s treatment,the number of Lactobacillus,Bifidobacterium,Enterococcus and Eubacterium in amoxicillin / clavulanate potassium group,ceftazidime group and drug combination group were significantly lower than those of control group（ P0.01）. The number of Enterobacteria in three group were significantly higher than that of control group（ P0.01）. Four kinds of probiotics in drug combination group were significantly lower than those in amoxicillin / clavulanate potassium group and ceftazidime group（ all P0.01）. Conclusion： There were no significantly differences in clinical effect on neonatal pneumonia among amoxicillin / clavulanate potassium,ceftazidime and combination drug use,but the impact on intestinal microflora of three groups was different among the three treatments,therefore the usage of antibiotics in treating neonatal pneumonia should be fully considered to improve clinical effect and avoid adverse reactions.