短期阿奇霉素治疗儿童急性中耳炎的疗效分析

摘要

Objective To evaluate the clinical efficacy of short-term azithromycin for acute otitis media in children .Methods From January 2013 to December 2016 ,109 children with acute otitis media in Maternal and Child Health Hospital of Hainan Province were randomly divided into standard treatment group (n = 55) and short course group (n = 54) .Azithromycin suspension 200mg/d was given ,and the course lasted 10d and 5d , respectively , and then patients were followed up for 4 to 6 months .Clinical symptoms ,onset time ,hospitalization time and adverse reactions were compared between two groups after treatment .Bacterial eradication rate and effective reduce rate of tympanic cavity pressure were detected .Results There were 51 and 48 patients in two groups completing the study at the end of treatment respectively .There were no significant differences in clinical symptom score , proportion of symptom score decreasing more than 50％ ,onset time ,hospitalization time and recurrence rate between groups (allP > 0 .05) .The failure rate of short course group (33 .33％ ) was higher than standard treatment group (15 .69％ ) with significant difference (χ2 = 4 .193 ,P < 0 .05) .Pathogen conversion rate of standard treatment group (78 .26％ ) was significantly higher than short course group (46 .43％ ) (χ2 = 5 .368 ,P < 0 .05) .There was on significant difference in tympanic pressure reduce rate between two groups (82 .35％ vs 77 .08 ,χ2 = 0 .426 ,P > 0 .05) .Adverse reaction rate was 3 .64％ and 7 .41％ in standard treatment group and short course group ,respectively ,and no statistically significant difference was found between two groups (χ2 = 0 .745 , P =0 .388) .Conclusion The 5d-course of azithromyc for acute otitis media is not superior to the 10d regimen ,and the side effects are not lower .%目的 评价短期阿奇霉素治疗儿童急性中耳炎的疗效分析.方法 选择2013年1月至2016年12月在海南省妇幼保健院就诊的急性中耳炎患儿109例,随机分为标准疗程组55例和短疗程组54例,给予阿奇霉素干混悬剂200mg/d,疗程分别为10d和5d,再随访4～6个月,比较两组治疗后临床症状 、起效时间 、住院时间和不良反应,同时检测两组病原体转阴率和鼓室压有效降低率.结果 两组分别有51例和48例患儿完成研究,治疗结束时临床症状评分 、症状评分下降>50％ 的比例 、起效时间 、住院时间和复发率组间比较差异无统计学意义(均P>0.05),而短疗程组治疗失败率(33.33％)大于标准疗程组(15.69％),组间比较差异有统计学意义(χ2=4.193,P<0.05);标准疗程组病原体转阴率(78.26％)大于短疗程组(46.43％),组间比较差异有统计学意义(χ2=5.368,P<0.05),而鼓室压有效降低率组间比较差异无统计学意义(82.35％vs 77.08％,χ2=0.426,P>0.05);标准疗程组和短疗程组不良反应发生率分别为3.64％ 和7.41％,组间比较差异无统计学差异(χ2=0.745,P=0.388).结论 急性中耳炎给予阿奇霉素5d疗程并不优于10d给药方案,同时不良反应亦不低于5d疗程组.