儿科支气管肺炎抗生素应用分析

Analysis of Antibiotic Use for Bronchial Pneumonia in Pediatrics

目的调查分析近8 a来内蒙古自治区人民医院儿科收治的支气管肺炎患儿抗生素应用情况的变化,提高儿科医师在临床工作中合理使用抗生素的意识及水平.方法应用回顾性调查研究方法,随机选取内蒙古自治医人民医院2008年1月至2011年12月儿科支气管肺炎住院患儿800例,2012年1月至2015年12月儿科支气管肺炎住院患儿800例,对抗生素使用情况进行统计和分析.从病历中调取病例及相关数据,对儿科支气管肺炎住院患儿抗生素用使用率、抗生素联合使用率、白细胞及中性粒细胞水平、病原送检率、住院时间及出院治愈率等进行调查统计分析.结果在上述两时间段儿科支气管肺炎住院患儿白细胞及中性粒细胞水平、出院治愈率差异无统计学意义(P>0.05)的情况下,2012年至2015年较2008~2011年抗生素使用率、抗生素联合使用率明显下降,三代头孢使用率下降,阿奇霉素使用率升高,病原送检率提高,住院时间缩短,差异均有统计学意义(P<0.05).结论儿科医生应加强对支气管肺炎患儿抗生素用药的重视,在保证相同的治疗效果,根据病原学检测结果,安全、有效、合理选择抗生素品种,使疾病治疗方式更注重针对病原治疗,减少不必要使用抗生素,从而减少对患儿不必要的损害.

Objectives To investigate and analyze the changes of antibiotic use for pediatric patients with bronchial pneumonia in recent eight years and to improve the awareness and the level of pediatricians in using of antibiotics in clinical work rationally.Methods Retrospective investigation was applied on800cases of pediatric bronchial pneumonia in Inner Mongolia People's Hospital from2008to2011and another800cases of pediatric bronchial pneumonia from2012to2015to analyze the use of antibiotics.The cases and related data were collected fromthe medical records.The use rate and combined use rate of antibiotics,white blood cell and neutrophil levels,pathogen detection rate,hospital stay and discharge rate were analyzed.Results There was no significant difference in leukocyte and neutrophil levels and hospital discharge rate between the two groups(P>0.05).The use rate and combined use rate of antibiotics in2012-2015cases were significantly lower than those in2008-2011cases.The pathogen detection rate in2012-2015cases was significantly higher than that in2008-2011cases and the length of hospitalization in2012-2015cases was significantly shorter than that in2008-2011cases(P<0.05).Conclusion Pediatricians should pay more attention to the administration of antibiotics on the children with bronchial pneumonia.Based on the results of etiological detection,safe,effective and rational choice of antibiotic can be helpful to reduce the unnecessary use of antibiotics,thereby reducing unnecessary damage to children.