Historical Cohort Study of the Efficacy and Safety of Piperacillin/Tazobactam Versus Fourth-Generation Cephalosporins for Empirical Treatment of Febrile Neutropenia in Patients with Hematological Malignancies

We retrospectively evaluated the efficacy and safety of the combination drug piperacillin/tazobactam (PIPC/TAZ) in comparison with those of fourth-generation cephalosporins (4th Cephs) as initial empirical treatment in hematological malignancies patients with febrile neutropenia (FN). Among 200 patients assessed in this study, 49 had received PIPC/TAZ and 151 4th Cephs. Patient background characteristics were comparable between the two treatment groups. The overall efficacy rate in those receiving 4th Cephs and PIPC/TAZ was 57.0% (86/151 patients) and 59.2% (29/49 patients), respectively, with no significant difference detected between the two treatment regimens (P = 0.78). Treat-ment did not need to be discontinued or interrupted due to development of adverse drug reactions in any of the patients. Therefore in this study the efficacy and safety of PIPC/TAZ as initial antimicrobial treatment for FN in patients with hematological malignancies were not inferior to those of 4th Cephs. Based on the preliminary data obtained in this study, we propose to conduct a multicenter, prospective, controlled study to compare PIPC/TAZ versus CFPM given as empirical antimicrobial treatment against FN in patients with hematological malignancies.

Selective Association between Cephalosporin, Quinolone, Macrolide, and Penicillin Antibiotic Consumption and Childhood Obesity in Europe

The accelerated weight gain in productive animals as a result of feeding antibiotic enriched fodder has been well known for decades. The better energy harvest is the result of modified gut microbiota as a consequence of applied antibiotics. Similar mechanisms might result obesity in humans as well. Objectives: Finding associations between global antibiotic consumption of different classes in EU countries and obesity data in adults and children prove that antibiotics might play a significant role in the development of obesity “epidemics” and related illnesses. Methods: Antibiotic consumption data were compared with obesity figures in adults and children in European countries and statistically analyzed for significance. Results: Significant correlation was found between the average yearly consumption of cephalosporins (p = 0.007), quinolones (p = 0.031), macrolides (p = 0.000083) and childhood obesity data, but no significant association was observed with the average penicillin consumption. No association was observed between adult obesity and any of the antibiotic classes studied. Conclusions: Our results support the hypothesis that different types of antibiotics might influence the development of obesity among children, and this finding can serve as a unified explanation for the development of obesity “epidemics”, similarly to the obesity and gut flora alteration-related diseases (type 2 diabetes mellitus, autism, etc.).

Nano-Coupling of Cephalosporin Antibiotics with Fe<SUB>3</SUB>O<SUB>4</SUB>Nanoparticles: Trojan Horse Approach in Antimicrobial Chemotherapy of Infections Caused by <i>Klebsiella spp</i>.

In the present study we had an aim to develop the methods of functionalizing the surface of magnetite nanoparticles with cefotaxime and ceftriaxone antibiotics. The quantitative analysis of the nanostructured cephalosporins was determined by Atom Absorbance Spectroscopy (AAS) and based on the Lambert-Beer law. The engineered nanostructures were tested on gram-negative microorganisms Klebsiella spp., of Enterobacteriaceae, and gram-positive bacteria Staphylococcus aureus, each having multi-drug resistance properties.

Kinetic spectrophotometric determination of certain cephalosporins using iodate/iodide mixture

A simple, precise and accurate kinetic spectro-photometric method for determination of ce-fradine anhydrous, cefaclor monohydrate, ce-fadroxil monohydrate, cefalexin anhydrous and cefixime in bulk and in pharmaceutical formula-tions has been developed. The method based on a kinetic investigation of the reaction of the free carboxylic acid group of the drug with a mixture of potassium iodate and potassium iodide at room temperature to form yellow coloured triiodide ions. The reaction was followed up spectrophotometrically by measuring the increase in absorbance at 352 nm as a function of time. The initial rate, fixed time, variable time and rate-constant methods were adopted for constructing the calibration curves but fixed time method has been found to be more applicable. The analytical performance of the method, in terms of accuracy and precision, was statistically validated;the results were satisfactory. The method has been successfully applied to the determination of the studied drugs in commercial pharmaceutical formulations. Statistical comparison of the results with a well established reported method showed excellent ag- reement and proved that there is no significant difference in the accuracy and precision.

Spectophotometric method for determination of certain cephalosporins using 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl)

A simple, accurate and precise spectrophotometric method has been proposed for the determination of eleven cephalosporins, namely;cefaclor monohydrate, cefadroxil monohydrate, cefalexin anhydrous, cefradine anhydrous, cefotaxime sodium, cefoperazone sodium, ceftriaxone sodium, ceftazidime penthydrate, cefazolin sodium, cefixime and cefpodoxime pro- xetil in bulk drug and in pharmaceutical formulations. The method depends on hydrolysis of the studied drugs using 0.5M NaOH at 100&#176;C and subsequent reaction of the formed sulfide ions with NBD-Cl (4-chloro-7-nitrobenzo-2-oxa-1, 3-diazole) to form a yellow-colored chromogen measured at 390 nm. Different variables affecting the reaction (e.g. NaOH concentration, hydrolysis time, NBD-Cl concentration and diluting solvent) were studied and optimized. Under the optimum conditions, linear relationships with good correlation coefficients (0.9990- 0.9999) were found in the range of 5-160 μg mL-1 for all studied drugs. The limits of assay detection and quantitiation ranged from 0.289 to 5.867 and from 0.878 to 17.778 μg mL-1;respectively. The accuracy and precision of the proposed method were satisfactory. The method was successfully applied for analysis of the studied drugs in their pharmaceutical formulations and the recovery percentages ranged from 96.6 to 103.5%.

Theoretical Insights Elucidate Novel Active Phosphonate Esters—Cephalosporin Antibiotics’ Intermediate

Theoretical insights elucidate a series of active phosphonate esters application in preparation of Cephalosporin antibiotics’ intermediate. The B3LYP/6-311+G(d,p) method was employed to obtain the stable equilibrium geometries including comparing to the AE-active ester. It was found that the Ethyl-aminothiazoly Loximate (AT) molecule fragment is almost planar sheet, but it is almost perpendicular to the plane of phosphoryl ester. Moreover, the calculated Mulliken atomic charge distribution and frontier molecular orbital analysis of these esters showed that the amino N atom connected to the Thiazole ring of the AT had the maximum negative charge, which suggested that this area had high molecular activity. The value of ΔEL-H was energy gap between EHOMO and ELUMO and indicated that compound 6a had high reaction activity. The theory calculation results can explain the reaction mechanism well and predict that the novel active phosphonate ester has a hopeful application prospect in preparation of Cephalosporin antibiotics’ intermediate.

Synthesis and Antibacterial Activity of New Cephalosporin Compounds

Five new cephalosporin compounds were designed and synthesized, and the antibacterial activities were evaluated by the standard serial 2-fold agar dilution method in vitro. The results showed that the activities of the compounds Ia and lb against ESBL E. coli and K. pneumoniae are comparable to those of Cefepime.

Variable selection in near infrared spectroscopy for quantitative models of homologous analogs of cephalosporins

Two universal spectral ranges(4550-4100 cm^(-1) and 6190-5510 cm^(-1))for construction of quantitative models of homologous analogs of cephalosporins were proposed by evaluating theperformance of five spectral ranges and their combinations,using three data sets of cephalos-porins for injection,ie.,cefuroxime sodium,cetriaxone sodium and cefoperazone sodium.Subsequently,the proposed ranges were validated by using eight calibration sets of otherhomologous analogs of cephalosporins for injection,namely cefmenoxime hydrochloride,ceftezole sodium,cefmetazole,cefoxitin sodium,cefotaxime sodium,cefradine,cephazolin sodium and ceftizoxime sodium.All the constructed quantitative models for the eight kinds of cephalosporinsusing these universal ranges could fulill the requirements for quick quantification.After that,competitive adaptive reweighted sampling(CARS)algorithm and infrared(IR)-near infrared(NIR)two-dimensional(2D)correlation spectral analysis were used to determine the scientific basis of these two spectral ranges as the universal regions for the construction of quantitativemodels of cephalosporins.The CAR.S algorithm demonstrated that the ranges of 4550-4100 cm^(-1) and 6190-5510 cm^(-1) included some key wavenumbers which could be attributed to content changes of cephalosporins.The IR-NIR 2D spectral analysis showed that certain wavenumbersin these two regions have strong correlations to the structures of those cephalosporins that wereeasy to degrade.

Studies on Semisynthesis and Anibacterial Activity of 7 β-(5-Methyl-1-Aryl-1H-1,2,3-Triazoly-4-Carboxamido) Cephalosporins

Nine new derivatives of 7 β - (5- methyl- 1- aryl- 1H-1, 2, 3- triazoly- 4- carboxamido) cephalosporins were synthesized by acylction of 7 β -amino group of 7-ACA, 7-ADCA and 7-ACT with 5 -methsyl- 1 -aryl- 1 H- 1,2,3-triazoly-4-formyl chloride. The structure of the compounds were confirmed by elementray analysis IR, HNMR and FAB-MS. Some of them showed significant antibacterial activity

Detection and Identification of Gonococci Resistance to Cephalosporin and Determination the Most Effective Empirical Treatment for Gonococcal Urethritis in Male Human in Egypt

Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is predictable to be untreatable disease in near future. WHO GASP, WHO GLASS and WHO’s global action plan on AMR recommends to expand nationally and internationally to collect data to monitor AMR of gonococci for public health policies. Objective: Our aim is to detect resistance of gonococci to Cepha- losporins and determine the most effective empirical treatment for un-com- plicated gonococcal urethritis in males in Egypt. Methods: We depended in our methodology on selected gonococci from male urethral discharge specimens on Thyer Martien medium;collected 33 isolates during three years from 2017 to 2020;used antibiotics with MIC according to international standards and measuring IZD according to antimicrobial susceptibility testing reference ranges in international standards. Results: By statistical studies, resistance to cephalosporins was as follows: Cephradine 97%, Cefaclor 87.9%, Cefoxitin 97%, Ceftriaxone 90.9% and 42.4% to Cefepime, that shows hetero-genecity in resistance inside cephalosporin group;while resistance to Macrolides group represented by Azithromycin and Tetracyclins group represented by Doxycycline was as follows: Azithromycin 39.4%, Doxycycilne 27.3%;finally fluoroquinolones, the most effective group, resistance, was as: Levofloxacin 15.2%, Ciprofloxacin 15.2% and Ofloxacin 24.2%. Conclusion: The most effective empirical treatment for uncomplicated gonococcal urethritis in males in EGYPT is Fluoroquinolone;especially Levofloxacin ranks first susceptibility as 78.8% and 15.2% resistance followed by Ciprofloxacin susceptibility as 69.7% and 15.2% resistance, finally Ofloxacin susceptibility as 66.7% and 24.2% resistance;for Ceftriaxone not more recommended in EGYPT as empirical treatment for uncomplicated gonococcal urethritis, it is susceptibility as 6.1% and 90.9% resistance;in addition, we can use combination therapy of Fluoroquinolones with Azithromycin or Doxycycline, whose susceptibility is 30.3% for Azithromycin and 42.4% for Doxycycycline, while resistance is 39.4% for Azithromycin and 27.3% for Doxycycline. It is worth noting that only Cefepime in Cephalosporins group represents 42.4% susceptibility and 42.4% resistance;in addition to the Carbapenems group, it represents as 42.4% susceptibility for Imipenem and 45.5% resistance, then 42.2% susceptibility for Meropenem and 48.5% resistance, which can play role in combination therapy.

Computational Calculations of Molecular Properties and Molecular Docking of New and Reference Cephalosporins on Penicillin Binding Proteins and Various β-Lactamases

An approach of using molinspiration calculations and molecular docking on PBPs （penicillin-binding proteins） and certain β-lactamases is employed to predict the molecular properties, bioactivity and resistance of newer and reference cephalosporins. The previously synthesized cephalosporins 1-8 and reference cephalosporins were subjected to extensive evaluations by calculating the molecular properties, drug-likeness scores on the bases of Lipinski＇s rule and bioactivity prediction using the method of molinspiration web-based software. The TPSA （topological polar surface area）, OH-NH interactions, n-violation and the molinspiration Log partition coefficient （miLogP） values were also calculated. The investigated cephalosporins were subjected to molecular docking study on PBPs （lpyy） and on β-lactamases produced by S. aureus, K. pneumonia, E. coil and P. auroginosa using 1-click-docking website. Molecular properties of 1-8 recorded higher ＂FPSA than cephalexin and were lower than the reference cephalosporins and do not fulfill the requirements for Lipinski＇s rule. Bioactivities of 1-8 were predicted to be less and their docking scores on PBPs were comparable to those of the reference cephalosporins, particularly ceftobiprole. The references recorded various docking scores on the above β-lactamases and as expected, cefiobiprole recorded the lowest scores on all β-lactarnases. Cephalosporins 1-8 recorded various docking scores on β-lactamases. Molecular docking studies on PBPs and β-lactamases are considered as very useful, reliable and practical approach for predicting the bioactivity scores and to afford some information about the stability and selectivity of the newly proposed cephalosporins against β-lactamases of certain pathogenic microbes, such as P. auroginosa and MRSA, by recording the relative docking scores in comparison with those of reference cephalosporins.

Molecular Characteristics of Cephalosporin-Resistant Neisseria gonorrhoeae Strains in China:A Retrospective Study

Objective:An increasing level of antimicrobial resistance to extended-spectrum cephalosporins has been reported,so we conducted this study to investigate the molecular characteristics of cephalosporin resistant Neisseria gonorrhoeae(NG)strains isolated from China Gonococcal Antimicrobial Resistance Surveillance Programme(China-GRSP).Methods:In total,2,038 NG isolates were collected from the China-GRSP between 2015 and 2016.NG multiantigen sequence typing(NG-MAST),multilocus sequence typing(MLST),and NG sequence typing for antimicrobial resistance(NG-STAR)were used to determine characteristics and resistant determinants of cephalosporin-resistant isolates.The results are described as percentages.Results:Seventy-four(3.6%)cephalosporin-resistant isolates were confirmed.MLST_(ST7363)was the most prevalent MLST among cefixime-resistant(CFX-R)isolates,whereas MLST_(ST7365)(n=8)in was the most prevalent sequence type among ceftriaxone-resistant(CRO-R)isolates.CFX-R strains were mainly associated with penA-X(n=27,44.3%),penA-XIII(n=6,9.8%),penA-XVIII(n=5,8.2%),and CRO-R strains were mainly related to penA-XVIII(n=10,25.6%),penA-43(n=9,23.1%),penA-XIII(n=7,17.9%).Conclusion:The main conclusion of this study is that the predominant cephalosporin-resistant clones in China include locally emerged and imported linages.The CFX-R and CRO-R strains are primarily related to penA mutations,and their predominant genotypes are different.With the increase in international travel,tracking high-risk-resistant clones and identifying outbreaks and their associations with epidemiological characteristics are critical to improve public health.

Analysis of Polymer Impurities in Cephalosporin Antibiotics

[Objectives]To establish a HPLC-MS method for the determination of polymer impurities in cefathiamidine and its preparations.[Methods]Kromasil 100-5 C_(18) column(4.6 mm ×250 mm,5μm)was used for analysis;mobile phase ammonium acetate solution(pH 6.30)-acetonitrile,gradient elution;volumetric flow rate 1.0 mL/min;column temperature 40℃;multi-reaction monitoring mode was used for analysis,and positive ion scanning was chosen as the electrospray ion source.[Results]The resolution between impurities and main peaks under this method was greater than 1.5,and 8 known impurities and 2 polymer impurities could be completely separated and distinguish-ed.It was inferred that the molecular ion peak[M+H]^(+):m/z727.1874,m/z 785.1937 was the possible polymer impurity of this product.[Conclusions]A method for the analysis of polymer impurities in cefathiamidine and its preparations was formed,which could achieve the purpose of simultaneous analysis of small molecule impurities and polymer impurities,and could better control the content of single impurities in the polymer,providing a reliable inspection basis for strict control of cefathiamidine quality.

Dissimilarity of different cephalosporins on volatile fatty acids production and antibiotic resistance genes fates during sludge fermentation and underlying mechanisms

The distinct influences of cephalosporins(CEPs, i.e., cefamandole nafate and cefpirome sulfate) affiliated to different generations on the volatile fatty acids(VFAs) production and antibiotic resistance genes(ARGs) fates during waste activated sludge(WAS) fermentation were unveiled. The presence of CEPs mainly exhibited negative effects on the total VFAs production(5%–15% reduction), especially the cefamandole nafate, which is quite different to previous understanding. Further investigation revealed that the CEPs contributed to the solubilization and hydrolysis but inhibited the acidification process by affecting the functional microbial populations(i.e., Tissierella) and general microbial metabolic activities(i.e., pyruvate metabolism and VFAs biosynthesis). In addition, CEPs(especially the cefpirome sulfate)caused the propagation of ARGs(i.e., bla TEM, tet X and mex F) during WAS fermentation. CEPs enhanced the cell membrane permeability to promote the antibiotics mechanism of efflux pump and the horizontal transfer of ARGs. Also, the CEPs altered the regulatory systems(i.e., two component system) and microbial populations associated with ARGs, resulting in the proliferation of specific ARGs. Overall, the dissimilarity of different CEPs impacts on the WAS fermentation for VFAs production and ARGs variations enlightened the diverse environmental behaviors of anthropogenic pollutants and evoked the caution of ecological risks.

静脉注射头孢菌素类药物患者过敏反应发生率及其影响因素的多中心临床研究

目的:分析头孢菌素类药物过敏反应的发生率及其影响因素。方法:横断面调研2021年4月1日至6月30日浙江省29家医疗机构所有接受静脉注射头孢菌素类药物的患者,统计头孢菌素类药物过敏反应的发生率,采用泊松回归模型分析头孢菌素类药物诱导过敏反应发生的相关影响因素。结果:研究共纳入56155例患者,头孢菌素类药物过敏反应总发生率为1.67‰,过敏反应发生率最高的是头孢唑肟(4.27‰),其次是头孢曲松(3.49‰)和头孢噻肟(2.40‰)。与皮试阴性组比较,非皮试组患者过敏反应发生率无明显增加(分别为1.75‰与1.63‰,RR=1.07,95%CI:0.70~1.63,P>0.05)。泊松回归分析结果显示,体重指数低于18.5 kg/m^(2)(RR=2.43,95%CI:1.23~4.82,P<0.05)、其他β-内酰胺类药物过敏史(RR=33.88,95%CI:1.47~781.12,P<0.05)会增加头孢菌素类药物过敏反应的发生率,且与头孢呋辛比较,头孢曲松(RR=3.08,95%CI:1.70~5.59,P<0.01)、头孢他啶(RR=1.89,95%CI:1.03~3.47,P<0.05)和头孢唑肟(RR=3.74,95%CI:1.64~8.50,P<0.01)过敏反应发生的风险增加。结论:头孢菌素类药物过敏反应与低体重指数和β-内酰胺类药物过敏史有关,头孢菌素类药物的常规皮试筛查并不能减少过敏反应发生。

第三代头孢菌素治疗社区获得性自发性细菌性腹膜炎效果预测模型的临床价值

目的探讨第三代头孢菌素(3^(rd)GC)治疗社区获得性自发性细菌性腹膜炎(CASBP)效果预测模型的临床应用价值。方法前瞻性选取2021年1月—2022年6月南昌市第九医院新入院的肝硬化伴CASBP患者50例,随机分为优化治疗组(n=25)与传统治疗组(n=25),前者基于效果预测模型采用头孢他啶或亚胺培南初治,后者均采用头孢他啶初治,此后依据初治效果调整抗生素,比较两组的初治有效率、第5天治愈率及30天病死率。计量资料两组间比较采用成组t检验或MannWhitney U检验。计数资料两组间比较采用χ^(2)检验或Fisher精确概率法。结果所有患者均完成研究。优化治疗组初治有效率明显高于传统治疗组(88.0%vs 60.0%,χ^(2)=5.094,P=0.024),两组第5天治愈率相当(80.0%vs 56.6%,χ^(2)=3.309,P=0.069)。均使用头孢他定初治的患者中,优化治疗组初治有效率亦明显高于传统治疗组(88.9%vs 60.0%,χ^(2)=4.341,P=0.037),两组第5天治愈率相当(83.3%vs 56.0%,χ^(2)=2.425,P=0.119)。两组患者的30天病死率分别为8.0%和20.0%,差异无统计学意义(χ^(2)=0.664,P=0.415)。所有入组患者初治有效与第5天治愈关联明显(OR=9.643,95%CI:2.292~40.564),第5天治愈与患者30天死亡关联明显(OR=0.138,95%CI:0.023~0.813)。结论该疗效预测模型有助于临床医生筛选3rdGC治疗的优势患者,提高3rdGC经验性治疗CASBP的初治疗效。

我国医务人员头孢菌素类药物皮试知信行的调查研究

目的分析我国医疗机构医务人员对头孢菌素类药物皮试的知信行现状及其影响因素,为规范皮试相关医疗行为提供参考。方法采用自行设计的头孢菌素类药物皮试知信行问卷对我国医务人员进行调查。通过微信向全国医疗机构发放问卷二维码,被调查者采用匿名方式自愿参加。统计不同文化程度,工作岗位、职称医务人员的知识、态度、行为得分,应用Wilcoxon秩和检验、多元线性回归分析等方法分析其影响因素。结果30个省份205家医疗机构的873名医务人员参与调查。对头孢菌素类药物皮试知识(总分16分)、态度(总分20分)、行为(总分20分)得分分别为10(8,12)分,13(12,15)分和12(9,15)分。多元线性回归结果显示,文化程度、工作岗位和职称与知识、态度得分相关(P<0.05)。研究生比专科医务人员知识掌握情况好、态度积极;药师比医生、护士知识掌握情况好、态度积极;中级、高级比初级及以下职称医务人员知识掌握情况好、态度积极。知识水平与态度正相关(P<0.05)。性别、工作岗位和职称与行为得分相关(P<0.05)。女性比男性医务人员行为消极,护士比药师行为积极;高级比初级及以下职称医务人员行为积极。知识水平、态度与行为正相关(P<0.05),态度在知识对行为影响中的中介效应差异无统计学意义(P=0.085)。结论我国医疗机构医务人员头孢菌素类药物皮试知信行有待加强,应结合不同岗位、职称等方面的知信行差异,对医务人员开展培训,以提升知识水平、树立积极态度、规范皮试相关医疗行为。

头孢类抗生素致敏红细胞检测与溶血性贫血的关系

【目的】探讨头孢类抗生素致敏红细胞检测与溶血性贫血的关系。【方法】收集在本院住院的996例患者(选择做血型检测及准备输血)的血液标本,使用抗球蛋白卡式法检测药物致敏的红细胞直接抗球蛋白试验(DAT)阳性情况,统计临床DAT检测结果及患者在临床中的科室分布。采用抗球蛋白卡式法对DAT阳性血液标本进行抗体分型,DAT阳性强度分布及分类、头孢类抗生素致敏红细胞检测,了解DAT阳性使用抗生素种类。观察患者是否发生溶血性贫血,分析头孢类抗生素致敏红细胞检测与溶血性贫血的关系。【结果】DAT阳性检出率为7.83%(78/996),其中内科患者DAT阳性率高于外科(P<0.05)。78例DAT阳性患者血液标本在抗球蛋白卡中的反应强度为1+、2+、3+、4+的占比分别为28.21%、24.36%、25.64%、21.79%,反应强度分布比较,差异无统计学意义(P>0.05)。DAT阳性分类中抗IgG、抗C3d、抗IgG+C3d占比分别为39.74%、33.33%、26.92%,DAT阳性分类构成比较,差异无统计学意义(P>0.05)。78例DAT阳性患者血液标本中,共检测出4种抗生素致敏红细胞9例,其中头孢克洛致敏红细胞占比均高于头孢哌酮舒巴坦钠、头孢吡肟、头孢他啶(P<0.05),其余抗生素种类间比较,差异均无统计学意义(P>0.05)。DAT阳性患者血液标本中,使用抗生素患者临床溶血性贫血发生率高于未使用抗生素者(P<0.05),使用抗生素致敏红细胞者溶血性贫血发生率高于抗生素未致敏者(P<0.05)。使用抗生素未致敏患者溶血性贫血发生率与未使用抗生素者比较,差异无统计学意义(P>0.05)。【结论】头孢类抗生素致敏红细胞检测与溶血性贫血存在一定的相关性。

阿莫西林克拉维酸钾联合第三代头孢类抗菌药治疗新生儿肺炎的临床效果及其对肠道菌群的影响

目的分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组(n=50)及参照组(n=50)。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义(P>0.05),治疗后两组患儿的降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell count,WBC)、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善(P<0.05),其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率(94.00%)与参照组的临床有效率(86.00%)比较差异无统计学意义(P>0.05);两组患儿的不良反应发生率比较差异无统计学意义(P>0.05),但其中研究组腹泻的发生率高于参照组(P<0.05)。结论在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药(头孢他啶)的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。