造血干细胞移植术后粒细胞缺乏期患儿抗生素应用研究进展

Research progress on antibiotic application in children after hematopoietic stem cell transplantation during neutropenia

目前造血干细胞移植术(hematopoietic stem cell transplantation,HSCT)是治疗儿童多种恶性血液病及部分非恶性血液病的唯一有效手段,近年来,HSCT在预处理方案优化、移植物选择等方面取得了较大进展。感染是HSCT后患儿粒细胞缺乏期主要的死亡原因之一,及时、合理使用抗生素可降低耐药的发生率及感染相关死亡率。现针对儿童HSCT后的粒细胞缺乏期,总结了预防性抗生素的使用、粒细胞缺乏期伴发热抗生素的选择及较常见的耐药菌感染抗生素选择,以供临床参考。

Infection is one of the main causes of death in children with agranulocytosis after hematopoietic stem cell transplantation(HSCT).Timely and rational use of antibiotics can reduce the incidence of drug resistance and infection related mortality.At present,HSCT is the only effective method for the treatment of a variety of malignant hematological diseases and some non malignant hematological diseases in children.In recent years,HSCT has made great progress in the optimization of conditioning regimen and graft selection.This paper summarized the use of prophylactic antibiotics,the selection of antibiotics in agranulocytosis with fever and the selection of antibiotics for common drug-resistant bacterial infection in children after HSCT,for clinical reference.