左氧氟沙星在儿科临床中的应用

Application status and safety of Levofloxacin in pediatric clinical practice

目的探讨左氧氟沙星在儿科临床中的应用现状和安全性。方法回顾性研究2017年1月1日至2022年12月31日首都医科大学附属北京儿童医院和北京儿童医院保定医院使用左氧氟沙星的住院患儿,收集患儿性别、年龄、体重、出院诊断、药品名称、给药剂量、给药途径、给药疗程、病原微生物、不良反应等资料。结果共纳入220例患儿,年龄1个月14 d至16岁7个月27 d,主要分布在学龄期(70例)、学龄前期(65例)、幼儿期(44例),占所有患儿数的81.37%。共计13个科室使用,主要集中在呼吸科(77例)、血液科(49例)、感染内科(47例)、儿童重症监护室(14例)、干细胞移植科(9例),占总病例数的89.08%。主要用于肺炎(150例)、全身播散性结核病(25例)、脓毒症(20例)及血液病合并感染(16例)的患儿。常见的病原为肺炎支原体(102例)、肺炎克雷伯菌(14例)、嗜麦芽窄食单胞菌(14例)、鲍曼不动杆菌复合群(10例)、金黄色葡萄球菌(9例)、铜绿假单胞菌(9例)。左氧氟沙星的用法用量中,单次给药剂量不足25例,超剂量使用9例,给药频次错误9例。与左氧氟沙星相关的药物不良反应共3例,其中2例胃肠道反应(1例腹泻,单次剂量15 mg/kg,临床治愈;1例恶心,临床好转),1例皮疹(临床好转),未见严重不良反应。结论左氧氟沙星在儿童中短期使用相对安全,应按照正确的用法用量给药,期间需要密切关注胃肠道系统、皮疹、肝肾功能、血液系统、血糖、心脏系统、神经系统等指标。

Objective To investigate the clinical application status and safety of systemic administration of Levofloxacin.Methods Hospitalized children treated with Levofloxacin from January 1,2017 to December 31,2022 in Beijing Children′s Hospital,Capital Medical University and Baoding Hospital of Beijing Children′s Hospital were retrospectively recruited.Clinical data like the gender,age,weight,discharge diagnosis,drug name,dosage,route of administration,course of treatment,pathogenic microorganisms,and adverse events were collected.Results A total of 220 children were included.The age of Levofloxacin use ranged from 1 month and 14 days to 16 years,7 months and 27 days.The use of Levofloxacin in children was mainly distributed in school age(70 cases),preschool age(65 cases),and early childhood(44 cases),accounting for 81.37%of all children.Children treated with Levofloxacin were admitted in a total of 13 departments,mainly included the respiratory department(77 cases),hematology department(49 cases),infectious medicine department(47 cases),pediatric intensive care unit(14 cases),and stem cell transplantation department(9 cases),accounting for 89.08%of all children.The use of Levofloxacin was mainly applied to children with pneumonia(150 cases),systemic disseminated tuberculosis(25 cases),sepsis(20 cases)and blood disease complicated with infection(16 cases).The common pathogens were Mycoplasma pneumoniae(102 cases),Klebsiella pneumoniae(14 cases),Stenotrophomonas maltophilia(14 cases),Acinetobacter baumannii complex(10 cases),Staphylococcus aureus(9 cases),and Pseudomonas aeruginosa(9 cases).The use and dosage of Levofloxacin were concerned,including insufficient single dose(25 cases),overdose(9 cases),incorrect dosing frequency(9 cases).There were 3 cases of adverse drug reaction of Levofloxacin,including 2 cases of gastrointestinal reactions(1 case of diarrhea,a single dose of 15 mg/kg,clinically cured;1 case of nausea,clinically improved),and 1 case of rash(clinically improved).Serious adverse drug reactions were not reported.Conclusions Levofloxacin is relatively safe for short-and medium-term use in children.It should be administered according to the correct usage and dosage.During the administration period of Levofloxacin,the gastrointestinal system,rash,liver and kidney functions,blood system,blood sugar,heart system,nervous system and other indicators should be closely concerned.