阿奇霉素联合头孢菌素使用时间与儿童社区获得性肺炎疗效关系  

The correlation between the treatment time of azithromycin combined with cephalosporin.in treatment of community-acquired pneumonia in children and the risk of treatment failure

作　　者：王志杰 张慧玉[2] 黄光举[2] WANG Zhijie;ZHANG Huiyu;HUANG Guangju(Department of Pediatrics,Mentougou District Hospital,Beijing 102300,China;不详)

机构地区：[1]北京市门头沟区医院/首都医科大学门头沟教学医院儿科,102300 [2]河北省唐山市妇幼保健院呼吸内科

出　　处：《河北医药》2022年第12期1872-1875,共4页Hebei Medical Journal

基　　金：河北省卫生健康委员会科研基金项目(编号:20181334)。

摘　　要：目的探讨阿奇霉素联合头孢菌素短疗程治疗儿童社区获得性肺炎是否会增加治疗失败的风险。方法选取2018年1月至2020年12月就诊的年龄>6个月的CAP患儿360例,均给予阿奇霉素联合头孢菌素类药物治疗,头孢菌素类药物主要包括头孢曲松钠、头孢噻肟钠、头孢哌酮钠舒巴坦钠。短疗程组患儿190例,联合用药5~7 d;长疗程组患儿170例,联合用药8~14 d。短疗程和长疗程CAP患儿主要结局指标包括:转入ICU治疗、住院时间延长、是否采取吸氧措施、呼吸道病毒检测阳性、临床疗效、退热消失时间、肺部啰音消失时间、咳嗽咳痰消失时间、血常规恢复正常时间、不良反应发生率、成本(C)-效果(E)分析。结果短疗程组与长疗程组CAP患儿在是否采取吸氧措施、呼吸道病毒检测阳性情况方面差异无统计学意义(P>0.05)。在转入ICU治疗及住院时间延长方面差异有统计学意义(P<0.05),短疗程组患儿转入ICU治疗发生率高于长疗程组治疗患儿(P<0.05)。在住院时间延长中,长疗程组CAP患儿显著高于短疗程组CAP患儿(P<0.05)。2组在临床总有效率退热时间、咳嗽咳痰消失时间、肺部啰音消失时间、血常规恢复正常时间和不良反应方面差异无统计学意义(P>0.05)。成本-效果和增量分析结果示长疗程组比短疗程组抗菌药物费用和住院费用成本效果高,每增加一个医疗单元抗菌药物费用增加138.20元,住院费用增加405.38元。结论在非复杂性社区获得性肺炎治疗中,短疗程(5~7 d)抗生素联合治疗与长疗程(8~14 d)治疗相比不会增加治疗失败风险。Objective To investigate the correlation between the treatment time of azithromycin combined with cephalosporin.in treatment of community-acquired pneumonia(CAP)in children and the risk of treatment failure.Methods A total of 360 children with CAP with age being>6 months who were treated in our hospital from January 2018 to December 2020 were enrolled in the study,who were by azithromycin combined with cephalosporins including ceftriaxone sodium,cefotaxime sodium and cefpiazone sodium sulbactam sodium.The patients were divided into short-course group(n=190),with the treatment course being 5~7 days,and long-course group,with the treatment course being 8~14 days.The admission time to ICU,length of hospital stay,the use of oxygen measures,positive respiratory virus test,clinical efficacy,pyretolysis time,and the disappearing time of lung rales and cough,and the time to return to normal blood routine,the incidence of adverse reactions,cost(C)/effect(E)ratio were observed and compared between the two groups.Results There were no significant differences in the use of oxygen measures and the positive rate of respiratory virus between the two groups(P>0.05).There were significant differences in ICU stay and the length of hospital stay between the two groups(P<0.05).The admission rate to ICU in short-course group was significantly higher than that in long-course group(P<0.05),and the length of hospital in long-course group was significantly longer than that in long-course group(P<0.05).There were no significant differences in the total clinical effective rate,the disappearing time of lung rales and cough,and the time to return to normal blood routine as well as the incidence of adverse reactions between the two groups(P>0.05).Moreover the cost-effectiveness analysis showed that the cost of antibiotics and hospitalization costs in long-course group were significantly higher than those in short-course group(P<0.05),and with the cost of antibiotics and hospitalization costs increasing by 138.20 yuan,and each additional medic

关 键 词：阿奇霉素 头孢菌素 社区获得性肺炎 儿童 

分 类 号：R725.631[医药卫生—儿科]