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目的 :评价美罗培南与头孢哌酮-舒巴坦治疗儿科产超广谱β-内酰胺酶(ESBLs)耐药菌致支气管肺炎的临床疗效及安全性。方法 :入选186例患儿病例,按用药情况分为美罗培南组与头孢哌酮-舒巴坦组,进行回顾性统计研究。采用spss 22.0统计软件进行数据处理,用t检验或χ2检验,比较两组间的基本资料齐同性,统计菌群分布及耐药率,分别计算细菌清除率、治疗有效率及抗菌药物费用。结果 :两组病例中共分离细菌186株,主要产ESBLs菌为大肠埃希菌(56.99%)和肺炎克雷伯菌(37.63%)。美罗培南组与头孢哌酮-舒巴坦组治疗儿科产ESBLs菌致支气管肺炎的细菌清除率分别为86.95%及57.44%,总有效率分别为82.60%和87.23%。日平均费用美罗培南组是头孢哌酮-舒巴坦组的7.5倍。结论 :美罗培南与头孢哌酮-舒巴坦治疗产ESBLs菌致支气管肺炎疗效确切,不良反应发生率低。对产ESBLs菌致患儿支气管肺炎首选美罗培南,头孢哌酮-舒巴坦可作为降阶治疗的备选药物。
Objective: To evaluate the clinical efficacy and safety of meropenem and cefoperazone-sulbactam in the treatment of bronchial pneumonia caused by pediatric ESBLs-producing bacteria. Methods: A total of 186 children were enrolled and divided into two groups: Meropenem group and cefoperazone-sulbactam group according to the drug use status. The data were retrospectively analyzed. Data were processed using spss 22.0 statistical software. The t test or χ 2 test was used to compare the basic information homogeneity, statistical flora distribution and drug resistance rate between the two groups. The bacterial clearance rate, treatment efficiency and antibacterial drug cost were calculated respectively. Results: A total of 186 strains of bacteria were isolated from the two groups. The major ESBLs-producing strains were Escherichia coli (56.99%) and Klebsiella pneumoniae (37.63%). The bacterial clearance rates of meropenem and cefoperazone-sulbactam group were 86.95% and 57.44%, respectively. The total effective rates were 82.60% and 87.23% respectively. The average daily cost of Meropenem group was 7.5 times that of cefoperazone-sulbactam group. Conclusion: Meropenem and cefoperazone-sulbactam are effective in treating bronchial pneumonia caused by ESBLs-producing bacteria, and the incidence of adverse reactions is low. For patients with bronchial pneumonia due to ESBLs-producing bacteria, meropenem and cefoperazone-sulbactam are candidates for the reduction of bronchial pneumonia.