重症细菌性肺炎患儿继发抗生素相关性腹泻临床分析

摘要

Obiective To study the clinical characteristics and therapeutic measures of the antibiotic associated diarrhea (AAD) in children with severe bacterial pneumonia. Methods The information of antibiotic use history in children with severe bacterial pneumonia from January 2013 to June 2013 was retrospectively analyzed. Results The incidence rate of AAD was 70.59%in children with severe bacterial pneumonia. According to the frequency, the third-generation cephalosporins, penicillin and carbapenems were the major causes of AAD. The percentage of the age≤3 y, the duration of antibiotic usage>7 d and the number of antibiotics≥2 were significantly higher in AAD children than in non-AAD children (χ2=89.81~119.45, P<0.001). All the patients were improved after cessation or change of antibiotics. Conclusions The incidence of AAD in children with severe bacterial pneumonia is high, which is related to the age, the duration of antibiotic usage and the combination use of antibiotics.%目的：探讨重症细菌性肺炎患儿抗生素相关性腹泻（AAD）的发病及用药情况。方法回顾性分析2013年1月-2013年6月重症细菌性肺炎患儿抗生素应用情况。结果187例患儿中，发生AAD 132例（70.59%）；引发AAD的常见抗菌药物依次为三代头孢类、青霉素类、碳青霉烯类等。AAD组患儿年龄≤3岁、抗生素治疗>7 d以及应用抗生素≥2种的比例均高于非AAD组，差异有统计学意义（χ2=89.81~119.45，P均<0.001）。AAD患儿经停用或换用抗生素后腹泻好转。结论重症细菌性肺炎患儿AAD的发生率较高，与患儿年龄、抗菌药物使用时间、抗菌药物联用有关。