阿奇霉素不同给药途径在儿科抗感染中发生不良反应的危险因素分析

Analysis on Risk Factors for Adverse Reactions of Different Administration Routes of Azithromycin in Pediatric Anti-infective Therapy

目的 :比较分析阿奇霉素不同给药途径在儿科抗感染中发生不良反应的危险因素分析。方法 :选取2013年2月—2017年12月我院使用阿奇霉素的住院或门诊患儿共计549例为研究对象,比较口服和静脉给药引起的不良反应发生率,对引发患儿不良反应的因素进行单因素分析,根据单因素分析结果,应用Logistic回归分析影响不良反应发生的独立危险因素。结果 :通过口服途径给药的不良反应发生率为9.52%,显著低于静脉途径给药的20.56%,差异有统计学意义(P <0.01);阿奇霉素相关不良反应产生的独立危险因素有:用药剂量不合理、给药浓度不合理、联合用药、用药频率不合理及适应症选择不合理。结论 :临床应用阿奇霉素时应尽量选择口服给药,并且严格把握用药适应症,严格按照药物说明书控制给药剂量、浓度、频率,减少不必要的联合用药,以降低阿奇霉素相关不良反应发生几率。

Objective: To compare and analyze the risk factors for adverse reactions of different administration routes of azithromycin in pediatric anti-infective therapy. Methods: A total of 549 inpatients or outpatients treated with azithromycin from February 2013 to December 2017 were selected as subjects investigated. The incidence of adverse reactions caused by oral and intravenous administration was compared, and a univariate analysis on adverse factors causing adverse reactions to children was made. Independent risk factors affecting the occurrence of adverse reactions was analyzed by Logistic regression analysis based on the univariate analysis. Results: The incidence of adverse reactions caused by oral administration was 9.52%, which was significantly lower than 20.56% caused by intravenous route(P<0.01). The independent risk factors for azithromycin-related adverse reactions comprised irrational dosage, irrational administration concentration, combined drug, irrational administration frequency and irrational selection of indications. Conclusion: Oral administration of azithromycin should be chosen as far as possible in clinical use, and the drug indications should be strictly controlled. The dosage, concentration and administration frequency should be strictly controlled according to the drug instructions, and the unnecessary combination should be reduced to reduce the incidence of azithromycin-related adverse reactions.