目的 分析儿童应用喹诺酮类药物的有效性与安全性.方法 回顾性分析2016年11月至2018年1月,北京儿童医院儿童重症监护室应用喹诺酮类药物治疗的重症感染患儿,收集其临床资料,判定临床疗效,观察用药安全性.结果 24例患儿应用喹诺酮类药物治疗,所用药物包括:左氧氟沙星、环丙沙星、莫西沙星.细菌感染初始治疗效果不佳者,根据药敏结果选择左氧氟沙星或环丙沙星治疗;肺炎支原体感染,大环内酯类药物疗效不佳或耐药基因阳性者,使用莫西沙星治疗.24例患儿中痊愈1例(4.2％),显效19例(79.1％),无效1例(4.2％),治疗期间自动出院3例(12.5％),有效率为83.3％.用药期间密切观察患儿神志、皮肤、关节和胃肠道功能等,密切监测血常规、肝肾功能,未见药物不良反应.结论 重症感染儿童应用喹诺酮类药物疗效提高,预后改善,并未出现与药物相关的不良反应,说明短期使用是安全的.儿童应用喹诺酮类药物为超说明书用药,临床药师应协助医师做好相关工作,降低医疗风险.%Objective To analyze the efficacy and safety of quinolones in children with severe infection. Methods Patients with severe infections treated in the Pediatric Intensive Care Unit of Beijing Children's Hospital from November 2016 to January 2018 were enrolled. The clinical data were collected and analyzed. Results Totally 24 children were treated with quinolones, including levofloxacin, ciprofloxacin and moxifloxacin. Patients with poor initial treatment were treated with levofloxacin or ciprofloxacin on the basis of drug sensitivity for bacterial infections. Moxifloxacin was used to treat Mycoplasma pneumoniae infection in patients poorly treated by macrolides antibiotics or macrolide-resistance gene positive. Among the 24 cases, 1 case (4.2 ％) was cured, 19 cases (79.1 ％) treated effectively, 1 case had no response (4.2 ％), and 3 cases (12.5 ％) discharged automatically during treatment, with a response rate of 83.3 ％. The consciousness, skin, joint and gastrointestinal function were closely observed; blood routine test, liver and kidney function were closely monitored. There were no adverse drug reactions during the period of medication. Conclusions Quinolones can improve efficacy and prognosis for pediatric patients with severe infections. There are no drug related adverse reactions, indicating a safe short-term use. The use of quinolones in children is super-instructive, and clinical pharmacists should assist physicians in doing related work and reduce medical risks.
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