30例肺部感染患者的抗菌药物应用分析

An Analysis of the Application of Antibiotics in 30 Patients with Lung Infection

目的 :调查临床肺部感染的抗菌药物使用情况 ,提出合理使用抗菌药物建议。方法 :3 0例有病原学检查结果的肺部感染患者 ,将其病原学检查之前的选药与药物敏感试验结果进行比较。结果 :17例真菌感染 ,在病原学检查之前仅 1例使用过大蒜素 ;在病原学检查后 ,仅 3例使用伊曲康唑 ,其他 13例用大蒜素 ,1例死亡。 9例G-杆菌感染中 ,仅 2例药物敏感试验前用药与药物敏感试验相符 ,4例可能相符 ,3例用药不当。 4例耐甲氧西林表皮葡萄球菌 (MRSE)感染 ,无一例用万古霉素。结论 :①真菌引起的肺部感染应引起重视。②应用抗真菌药物应规范。③经验用药对条件致病菌和真菌引起的感染无效。④针对MRSE ,不应放弃首先选用万古霉素的原则。

Objective:To investigate the situation of the application of antibiotics in patients with lung infections so as to offer proposals for rational use of antibiotics. Method:30 cases of lung infections whose pathogens had been identified were studied. The choice of antibiotics before identification of pathogens was compared with the results of drug sensitivity tests. Results:Before pathogen identification, only 1 of the 17 patients with mycotic infection was given garlicin, and after pathogen identification, only 3 were treated with itraconazde and the other 13 with garlicin. The remaining 1 patient died. In only 2 of the 9 patients with gram negative bacilli infection, the choice of drug before drug sensitivity test tallied with the test. In 4 patients, it tallied with the test questionably. In 3 patients, the choice was inappropriate. None of the 4 patients with MRSE infection was treated with vancomycin. Conclusion:①Attention should be paid to mycotic infections of the lung. ②The use of antifungal agents should conform to the standard. ③Empirical medication is ineffective for infections caused by opportunistic pathogens or fungi. ④For MRSE infection the drug of first choice should be vancomycin.