重症监护病房中肺部感染的抗生素应用探讨  

The antibiotics application the ICU patients with lung infection

作　　者：朱会耕[1] 曹同瓦[1] 叶若兰[1] 

机构地区：[1]上海医科大学华山医院

出　　处：《中国抗生素杂志》1997年第3期238-241,共4页Chinese Journal of Antibiotics

摘　　要：在重症监护病房（ＩＣＵ）中１８９例伴有肺部感染的病人分成甲、乙两组，分别给予氨基糖苷类抗生素和第三代头孢菌素治疗，并在治疗前后随访其临床症状、体征、血白细胞计数、胸片和痰细菌学检查。发现甲组中硫酸妥布霉素和其他氨基糖苷类抗生素的临床有效率分别为８２．５％和６０．５％，前者细菌阴转率等均高于后者；乙组中头孢哌酮／舒巴坦和其他第三代头孢菌素临床有效率分别为８８．４％和７５．０％，前者细菌阴转率等均高于后者。结合实验结果对重症监护病房中的肺部感染病人，提议适当的治疗方案。We divided the 189 ICU patients with lung infection into 2 groups A and B: We treated them with aminoglycoside antibiotics and the third generation cephalosporin respectively. Before and after the treatment, we had observed the patients′clinical signs, symptoms, WBC, chest X ray and sputum bacteria examinations. From the observation, we found that the clinical efficacy rate of the A group treated with aminoglycoside antibiotics were 82.5% for tobramycin sulfate and 60.5% for other aminoglycoside anbiotics. And the former had higher negative rate for the sputum bacteria than the latter. As for the B group, the clinical efficacy rate of cefoperazone/sulbactam and other third cephalosporins were 88.4% and 75.0% respectively. And the former produced a higher negative rate for the sputum bacteria than the latter. So we come to a conclusion that when we′re treating the ICU patients with lung infections, the appropriate choice of antibiotic before we find the pathogenic bacteria is aminoglycoside such as tobramycin, and simultaneonsly we′d better use antibiotics which are active against Gram positive bacteria. If those antibiotics are ineffective or less effective to some patients than treat the patients with the third cephalosporin such as cefoperazone/sulbactam.

关 键 词：肺部感染 硫酸妥布霉素 头孢哌酮 重症监护病房 

分 类 号：R563.05[医药卫生—呼吸系统] R978.1[医药卫生—内科学]