儿童沙门菌肠炎临床用药疗效比较分析

Comparative Analysis of Clinical Efficacy of Salmonella Enteritis in Children

目的总结近两年内我科沙门菌临床特征,回顾性分析比较141例沙门菌肠炎用药疗效,以提高临床治愈率。方法 141例沙门菌肠炎根据大便培养药敏结果分为对β-内酰胺类抗生素敏感组和耐药组,比较两组间平均住院日统计学差异,并根据选择不同抗菌药进行疗效对比。结果本文中沙门菌属对β-内酰胺类抗生素耐药率高达23.40%;耐药菌组较敏感菌组平均住院日稍长(P<0.05);敏感菌组内头孢呋辛疗效差,与头孢曲松、头孢哌酮他唑巴坦钠和头孢他啶疗效相比,差异有统计学意义(P<0.05),头孢三代抗菌药疗效相比较差异无统计学意义;耐药菌组中口服复方新诺明片和庆大霉素片总有效率高,头孢哌酮钠他唑巴坦钠在头孢组中总有效率最高。结论细菌性肠炎应尽早行大便培养明确致病菌,并获得药物敏感信息指导临床用药;沙门菌属β-内酰胺类抗生素敏感菌,首选三代头孢,β-内酰胺类抗生素耐药菌可选用带酶抑制剂的三代头孢,或根据药物敏感结果选用口服复方新诺明片和庆大霉素片。

Objective To summarize the clinical features of Salmonella in our hospital in recent two years,and retrospectively analyze and compare the efficacy of Salmonella enteritidis in 141 cases to improve the clinical cure rate.Methods 141 cases of Salmonella enteritidis were divided into茁-lactam antibiotic sensitive group and drug-resistant group according to the sensitization results of stool culture.The average length of stay between the two groups was compared,and the curative effect was compared according to different antibacterials.Results In this paper,the resistant rate of Salmonella to茁-lactam antibiotics was as high as 23.40%;the average length of stay in drug-resistant bacteria group was slightly longer(<0.05);Effect of sensitive bacteria group and cefuroxime,ceftriaxone,cefoperazone sodium and tazobactam compared with ceftazidime treatment,there were significant differences(<0.05),the three generation cephalosporin antibiotic curative effect compared with no significant difference;drug-resistant group oral cotrimoxazole tablets and celebrate the total effective rate of gentamicin tablets high,cefoperazone sodium and tazobactam sodium in the group of the total effective rate was highest.Conclusion Bacterial enteritis should be done as early as possible stool culture specific pathogenic bacteria,and drug sensitive information to guide the clinical medication;Salmonella is a sensitive strain of茁-lactam antibiotics.The three generation cephalosporin,the lactam antibiotic resistant bacteria,the three generation cephalosporin with enzyme inhibitors can be selected,or the compound sulfamethoxazole tablet and gentamycin tablet are selected according to the drug sensitivity results.