周燕文 周冠强 周燕文 南宁 530027 广西医科大学一附院；周冠强 进修生，北海市中医院 中国现代应用药学 1999 0 16 3


    关键词：抗生素；合理；使用；呼吸系统；儿童 期刊 zgxdyyyx 0 医院药学 fur -->


    

摘要 目的 ：了解呼吸系统感染患儿抗生素的选用，评价其使用的合理性。方法：回顾性调查我院呼吸系统感染住院患儿的抗生素使用情况。结果：778例住院患儿中，抗生素的使用率为99.74%；抗生素疗程在10d以内的占83.93%；使用抗生素疗程最长的为29d，治疗中不更换抗生素的百分率为60.31%；抗菌治疗中抗生素的二联应用的百分率为72.91%，其中，β-内酰胺类抗生素同类二联应用率为57.84%，不良反应发生率为7.07%。一次住院期间使用5种以上抗生素的百分率为17.00%；住院期间用抗生素最多为10种；用抗生素前作药敏试验的百分率为36.29%，抗生素与激素联用的百分率为22.95%，与抗病毒药联用的百分率为17.40%；在应用阿米卡星的342例次中，有136次联合庆大霉素雾化吸入给药，占39.77%，其中2岁以下者占49.26%。总治愈率为80.08%；不良反应的发生率为8.10%。结论：我院呼吸系统感染住院患儿的抗生素的选用基本合理。应严格氨基糖苷类抗生素在儿科的应用适应症，特别是在尚不会说话或尚不能表达自己的感受的幼儿中应尽量避免使用。本次结果显示：β-内酰胺类抗生素同类二联应用不良反应发生率高于β-内酰胺类抗生素单用的不良反应发生率。

Investigation of antibiotics utilization in 778 respiratory system infection hospitalized children

Zhou Yanwen(Zhou YW),Zhou Guanqiang(Zhou GQ)(Guangxi Medical University,Nanning 530027)

ABSTRACT OBJECTIVE ：To evaluate the selection and reasonability of antibiotics in respiratory system infected children.METHOD:The use of antibiotics in hospitalized respiratory system infected childen was reviewed.RESULTS:Among 778 hospitalized children,the use percentage of antibiotics was 99.74%,the course of treatment in 10 days was 83.93% and the longest course was 29 days.The un-change rate of antibiotics in the treatment was 60.31%,the combined use rate of two antibitics was 72.91%,in which,the use of the two β-lactams was 57.84% and the incidence of adverse reactions was 7.07%,the percentage of using more than 5 kinds of antibiotics in one hospitalized period was 17.00% and the maximum of antibiotics used in hospital was 10,before antibiotics utilization,the rate of antimicrobial susceptibility testing was 36.29%.The ratesot antibiotics combined with hormone and antiviral were 22.95% and 17.40% respectively.Among 342 children using amikacin,there were 136 who took antibiotics combined with gentamicin which was given by vaporized inhalation(39.77%),in which 49.26% of the children were below two years old.The total cure rate was 80.08%,the incidence rate of antibiotics-related adverse reactions was 8.10%.CONCLUSION:The choosing of antibiotics in the treatment of respiratory system infected children was reasonable.More attention should be paid to the added toxicity resulted from aminoglycosides combined treatment by different rout,we must to confine rigidly the indications of aminoglycosides in the chilldren ward,particularly for the infant who can't speak or can't express their feelings should avoid using as far as possible.The results suggested that the incidence of two β-lactams antibiotics combined use-related adverse reaction was higher than β-lactams alone.

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