抗菌药物致神经系统不良反应发生情况回顾性分析

Retrospective analysis of adverse reactions of nervous system caused by antibiotics

目的探讨抗菌药物致神经系统不良反应发生情况及危险因素。方法统计安徽医科大学第三附属医院2003年1月~2019年6月上报的药物不良反应(ADR)报表,其中与抗菌药物有关的神经系统不良反应病例共103例,分析发生神经系统不良反应患者的性别、年龄、服药后ADR出现的时间、用药剂量、药物剂型、给药方式、联合用药等。结果 103例患者中70岁以上占比最高(33.0%);引起神经系统不良反应的抗菌药物最常见的是氟喹诺酮类(49.1%)、头孢菌素类(14.2%)、大环内酯类(9.4%)、三唑类(8.5%),单一品种中克林霉素、伏立康唑、莫西沙星发生率最高;神经系统ADR主要发生在给药1 d内(87.7%);静脉给药、联用其他易致神经系统ADR的药物等是易出现神经系统ADR的危险因素。结论抗菌药物致神经系统不良反应应引起足够重视,谨慎选择抗菌药物、采取个体化给药方案、加强用药监护,对减少神经系统不良反应至关重要。

Objective To investigate the occurrence and risk factors of nervous system adverse reaction induced by antibiotics.Methods The adverse drug reaction(ADR)reported in the Third Affiliated Hospital of Anhui Medical University from January 2003 to June 2019 were analyzed,including 103 cases of neurological adverse reactions related to antibiotics.The gender,age,time of occurrence of ADR,dosage,dosage form,mode of administration and combination of drugs were analyzed.Results The rate of over 70 years old was the highest in 103 patients(33.0%).The most common antibiotics causing adverse reactions of nervous system were fluoroquinolones(49.1%),cephalosporins(14.2%),macrolides(9.4%),triazoles(8.5%),the incidence of Clindamycin,Voriconazole and Moxifloxacin was the highest among the single cultivars.ADR of nervous system mainly occurred within one day after administration(87.7%).Conclusion The ADR of nervous system caused by antibiotics should be paid enough attention.Careful selection of antibiotics,individualized administration and intensive drug monitoring are essential to reduce the adverse reactions of nervous system.