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目的观察环丙沙星对新生儿院内感染的疗效及安全性。方法选择2009-2010年在新生儿科住院时发生院内感染的168例新生儿,92例新生儿给予环丙沙星治疗,76例给予其他敏感抗生素治疗(对照组)。在治疗前治疗后第7,14,21 d,检测2组的白细胞和血小板计数、血清转氨酶、胆红素、白蛋白、尿素、肌酐。评估2组(n=50,38例)在出生后6个月时生长发育情况。结果分离培养的病原菌以革兰阴性杆菌占优势(占73.8%),前3位分别是肺炎克雷伯菌(64%)、凝固酶阴性葡萄球菌(30%)、大肠埃希菌(22%)。这3种菌对环丙沙星的敏感性分别为92%,82%,100%。所有病原菌对环丙沙星的总敏感性为90%。环丙沙星组治愈率72.8%,总有效率88.0%,与对照组(70.6%,89.2%)比较无显著性差异(P>0.05)。随访半年,未发现环丙沙星组的患儿出现关节病的改变。结论环丙沙星治疗新生儿院内感染效果良好,也较安全。
Objective To observe the efficacy and safety of ciprofloxacin in neonatal nosocomial infection. Methods A total of 168 newborns with nosocomial infections during 2009-2010 hospitalization were enrolled. 92 newborns were treated with ciprofloxacin and 76 with other sensitive antibiotics (control group). On the 7th, 14th and 21st day after treatment, leukocytes and platelet counts, serum aminotransferase, bilirubin, albumin, urea and creatinine were measured in two groups. Two groups (n = 50, 38 cases) were evaluated for growth and development at 6 months after birth. Results Gram-negative bacilli were predominant (73.8%). The top three were Klebsiella pneumoniae (64%), coagulase negative staphylococcus (30%), Escherichia coli (22% ). The sensitivity of these three kinds of bacteria to ciprofloxacin was 92%, 82% and 100% respectively. The total sensitivity of all pathogens to ciprofloxacin was 90%. The cure rate of ciprofloxacin group was 72.8%, the total effective rate was 88.0%, which was not significantly different from that of control group (70.6%, 89.2%) (P> 0.05). Six months of follow-up, no changes were found in the children with ciprofloxacin. Conclusion Ciprofloxacin treatment of neonatal nosocomial infections with good results, but also more secure.