不明原因发热与抗菌药物合理应用  

Fever of unknown origin and rational use of antibiotics

作　　者：王西华[1] 蔡丽婷[2] 王西勇[3] 

机构地区：[1]东南大学附属中大医院呼吸科,江苏南京210009 [2]东南大学医学院临床医学系,江苏南京210009 [3]宿州市立医院ICU,安徽宿州234000

出　　处：《中华医院感染学杂志》2013年第21期5288-5290,共3页Chinese Journal of Nosocomiology

基　　金：江苏省自然科学基金项目(BK2009274)

摘　　要：目的探讨不明原因发热(FUO)的病因分布及抗菌药物的应用情况,为FUO的抗菌药物应用提供依据。方法回顾性分析2007年1月-2011年12月医院呼吸科住院且符合FUO诊断标准的78例患者的病因、诊断方法及抗菌药物使用情况。结果 78例患者中确诊病例为73例,确诊率为93.59%;感染性疾病18例占23.07%,非感染性疾病55例占70.51%,恶性肿瘤14例占17.95%,出院时仍未能明确诊断疾病5例占6.41%;78例FUO患者中入院前使用抗菌药物的有73例,占93.59%,抗菌药物使用1～6种、平均(2.81±1.36)种;78例FUO患者入院后使用抗菌药物的有52例,占66.67%,抗菌药物使用1～7种、平均(1.65±1.63)种。结论非感染性疾病已上升为FUO的主要原因,临床上FUO病因明确前,不合理使用抗菌药物的情况较为严重,应加强抗菌药物管理并制定FUO诊疗规范。OBJECTIVE To investigate the distribution of causes of fever of unknown origin （FUO） and the use of antibiotics so as to guide the use of antibiotics for FUO. METHODS A total of 78 patients who were complied to the diagnosis criteria of FUO and hospitalized the respiratory medicine department from Jan 2007 to Dec 2011 were enrolled in the study, then the causes of illness, diagnosis methods , and use of antibiotics were retrospectively analyzed. RESULTS Of totally 78 cases of patients , there were 73 （93. 59% ）confirmed cases, including 18 （23.07%）cases of infectious diseases, 55 （70. 51%） cases of non-infectious diseases, 14 （17. 95%） cases of malignant tumor, and 5 （6. 41%） cases of diseases without being confirmed until discharge. Of 78 cases of patients with FUO, there were 73 （93.59 %） cases of patients who used antibiotics before the admission. Various kinds of antibiotics were used （range： 1 to 6） with an average of （2. 81 ± 1. 36） kinds; 52 of 78 cases used antibiotics after the admission, accounting for 66.67%, and various kinds of antibiotics were used （range： 1 to 7） with an average of（1.65±1.63）kinds. CONCLUSION Non-infectious disease has become the main cause of FUO, the use of antibiotics is seriously unreasonable before the causes of FUO are made clear, and it is necessary to strengthen the administration of antibiotics and fdrmulate guidelines for diagnosis and treatment of FUO.

关 键 词：不明原因发热 病因分析 抗菌药物 

分 类 号：R978.1[医药卫生—药品]