儿科住院患者与抗生素相关的不良药物反应发生率及危险因素分析  

Analysis of the Incidence and Risk Factors of Antibiotic-related Adverse Drug Reactions in Hospitalized Pediatric Patients

作　　者：张忠刚 王洪 孙敬 ZHANG Zhong-gang;WANG Hong;SUN Jing(Emergency Department,Qinghai Women's and Children's Hospital,Xining 810007,Qinghai,China;Digestive Department,Qinghai Women's and Children's Hospital,Xining 810007,Qinghai,China)

机构地区：[1]青海省妇女儿童医院急诊科,青海西宁810007 [2]青海省妇女儿童医院消化科,青海西宁810007

出　　处：《医学信息》2021年第20期108-111,共4页Journal of Medical Information

摘　　要：目的分析儿科住院患者中与抗生素相关的不良药物反应(ADR)发生率和危险因素。方法选取2018年1月-2020年1月于我院住院治疗的儿童患者359例为研究对象,研究抗生素相关ADR发生率及严重程度,分析ADR的危险因素。结果住院儿童患者抗生素类药物使用中青霉素(64.07%),头孢菌素(55.99%)和大环内酯类(18.11%)最常见。ADR的发生率为16.43%,6例轻度(10.17%),中度45例(76.27%),重度8例(13.56%)。与头孢曲松、阿奇霉素和青霉素有关的ADR较为常见,分别有24例(40.68%)、13例(22.03%)、10例(16.95%)。ADR影响最多的器官系统是胃肠道45例(76.27%)和皮肤14例(23.73%);多因素Logistics回归分析结果显示,年龄<2岁、过敏史/ADR史、合并症、抗生素使用种类≥3种、住院时间≥5 d为ADR的独立危险因素(P<0.05)。结论儿童住院患者大多数抗生素相关ADR为轻中度,错误处方和错误检测是可避免ADR发生的主要原因,监测儿童中抗生素的使用对于确保这些患者的安全至关重要。Objective To analyze the incidence and risk factors of antibiotic-related adverse drug reactions(ADR)in hospitalized pediatric patients.Methods A total of 359 children hospitalized in our hospital from January 2018 to January 2020 were selected as subjects to study the incidence and severity of antibiotic-related ADR and analyze the risk factors of ADR.Results The most common use of antibiotics in hospitalized children was penicillin(64.07%),cephalosporins(55.99%)and macrolides(18.11%).The incidence of ADR was 16.43%,6 cases were mild(10.17%),45 cases(76.27%)were moderate,and 8 cases(13.56%)were severe.ADRs related to ceftriaxone,azithromycin and penicillin were more common,with 24 cases(40.68%),13 cases(22.03%),and 10 cases(16.95%)respectively.The organ systems most affected by ADR were the gastrointestinal tract in 45 cases(76.27%)and the skin in 14 cases(23.73%).Multivariate logistic regression analysis showed that age<2 years old,history of allergy/ADR,comorbidities,types of antibiotics≥3,hospital stay≥5 days were independent risk factors for ADR(P<0.05).Conclusion Most of the antibiotic-related ADRs in hospitalized children are mild to moderate.Wrong prescription and wrong detection are the main reasons of avoidable ADR.Monitoring the use of antibiotics in children is very important to ensure the safety of these patients.

关 键 词：住院儿科患者 抗生素 药物不良反应 

分 类 号：R969.3[医药卫生—药理学]