某院新生儿科预防性抗真菌药物应用分析

Application of prophylactic antifungal agents in neonatal department

目的探讨我院新生儿科预防性抗真菌药物应用情况,为优化新生儿科预防真菌感染的管理模式及临床合理用药提供参考。方法统计分析我院2017-2020年新生儿科收治的53例预防性应用抗真菌药物的新生儿,记录预防用药的指征、品种、剂量、疗程等。结果53例预防性应用抗真菌药物治疗的新生儿中,预防用药指征为早产儿、低出生体重、较长住院时间、长期胃肠外营养、长期使用广谱抗菌药物,预防性应用抗真菌药物为氟康唑,剂量3 mg/(kg·d),q72h,预防用药疗程1~5周,预防期间并未发现抗真菌药物相关不良反应。结论氟康唑用于预防性新生儿真菌感染安全有效,对合并2个以上真菌感染高危因素患者,建议经验性启用预防抗真菌药物治疗,疗程不超过4周。

Objective To investigate the application of prophylactic antifungal agents in neonatal department of our hospital,and to provide reference for clinical rational drug use and explore a better management mode of preventing fungal infection in neonatal department.Methods A total of 53 newborns with prophylactic antifungal agents in our hospital from 2017 to 2020 were investigated,and the indications,varieties,dosage and course of prophylactic drugs were analyzed.Results The indications of prophylactic antifungal agents were premature infants,low birth weight,long hospital stay,long-term intravenous nutrition and long-term use of broad-spectrum antibiotics.The prophylactic antifungal agents were fluconazole 3 mg/(kg·d),q72h,1~5 weeks.No adverse reactions related to antifungal drugs were found during prevention.Conclusion Fluconazole is effective and safe for the prevention of neonatal fungal infection.For the combination of more than two high-risk factors of fungal infection,it is recommended to empirically use preventive antifungal drugs,and the course of treatment should not exceed 4 weeks.