某儿童医院应用替加环素治疗8岁以下儿童重症感染50例分析

Analysis of 50 Cases of Severe Infection in Children under 8 Years Treated with Tigecycline in a Children’s Hospital

目的:探讨替加环素治疗儿童重症感染的疗效及安全性。方法:采用回顾性研究方法,收集上海市儿童医院2015年12月至2018年7月根据细菌培养结果或临床经验给予替加环素治疗的8岁以下儿童50例,通过对不同基础疾病、感染部位和病原体的分析,评价临床疗效及安全性。结果:50例患儿中,治愈34例(68. 0%),无效16例(32. 0%);10例(20. 0%)出现不良反应,主要表现为丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胆红素升高,凝血酶原时间和活化部分凝血活酶时间延长。结论:替加环素是8岁以下儿童危重症感染尤其是多重耐药菌感染治疗药物的一个选择,但其有效性和安全性需要大规模、多中心的临床试验进一步证实。

Objective:To probe into the efficacy and safety of tigecycline in the treatment of severe infection in children. Methods:Retrospective study method was adopted,totally 50 cases of children under 8 years who were treated with tigecycline according to bacterial culture results or clinical experience were collected from Shanghai Children’s Hospital from Dec. 2015 to Jul. 2018. The clinical efficacy and safety were evaluated by analyzing different basic diseases,infection sites and pathogens. Results:Of the 50 children,34 cases were cured( 68. 0%) and 16 cases were invalid( 32. 0%). And 10 cases( 20. 0%) had adverse drug reactions,mainly manifested as increase of alanine aminotransferase( ALT) and asparagine transaminase( AST) and bilirubin,prolonged prothrombin time and activation time of partial thromboplastin. Conclusion:Tigecycline is an alternative for the treatment of severe infection in children under 8 years,especially multi-drug resistant bacteria. However,its efficacy and safety need to be further confirmed by large scale,multi-centre clinical trials.