第三代头孢菌素联合阿奇霉素治疗小儿肺炎的可行性与疗效评价090423.docVIP

，？，。 、。 、 第三代头孢菌素联合阿奇霉素治疗小儿肺炎的可行性与疗效评价 王永莉，吴生美，马延华 （延安市人民医院，陕西 延安 716000）Feasibility and Evaluation of Curative effect of Third-generation Cephalosporins with Azithromycin in Injection on Children Pneumonia MA Yan-hua， DAI Yu-ting， KE Hai-hong People’s Hospital of Yan’an, Shaanxi Province, Shaanxi Yan’an 716000, China [Abstract] Objective: To investigate the curative effect of third-generation cephalosporins with Azithromycin in injection on children pneumonia. Methods: Pediatric patients with pneumonia were randomly divided into two groups. The trearment group was treated with third-generation cephalosporins with Azithromycin in injection, while the control group was given only third-generation cephalosporins, and then comparison was made between two groups in curative effects. Results: The effect of the treated group was obviously superior to that of the control group. There were significant statistic differences in the fading time of defervescing, the fading time of coughing, the fading time of crackles and rale and the days of hospitalization(P0.025). Conclusions: The curative effect of third-generation cephalosporins with Azithromycin in injection on children pneumonia is obvious that can shorten the course of disease, which would be worth for clinical applying. [Key words] Third-generation Cephalosporins; Azithromycin; Children 小儿肺炎是儿科疾病中最常见的下呼吸道感染疾病，病原体十分多样化，快速诊断困难大，四季均易发生，以冬春季为多。临床表现为发热、咳嗽、呼吸困难，也有不发热而咳喘重者。如果治疗不彻底，易反复发作，影响孩子发育。随着近几十年来抗菌素的广泛应用，尤其是β-内酰胺类抗菌素的广泛应用当前，细菌耐药性的问题正日益成为全球医药界共同关注的焦点。针对抗菌素耐药情况，在小儿肺炎的治疗中如何合理选用抗生素就显得日趋重要。许多儿科专家比较认可的治疗方案有：(1)碳青霉烯类抗生素如伊米配能。(2)头霉烯类抗生素，如头孢西酊。(3) β -内酰胺酶抑制剂。(4) β -内酰胺酶抑制剂+氨基糖苷类抗生素。(5)第三头孢菌素 + 大环内酯类抗生素。据统计资料显示，国内小儿肺炎的主要病原体为细菌：肺炎球菌、流感嗜血杆菌、肺炎克雷伯菌、军团菌等。近年来肺炎支原体感染有明显上升趋势。我们选用头孢类抗生素与阿奇霉素(属大环内酯类抗生素)联用治疗小儿肺炎 300 例，现报告如下： 1、第三代头孢菌素与阿奇霉素药理分析 头孢菌素类Cephalosporins)是由冠头孢菌培养液中分离的头孢菌素C，经改造侧链而得到的一系列半合成抗生素。其优点是：抗菌谱广，对厌氧菌有高效；引起的过敏反应较青霉素类低；对酸及对各种细菌产生的β-内酰胺酶较稳定；抑制细菌细胞壁的成而达到杀菌的目的。由于其不良反应和毒副作用较低，是当前开发较快的一类抗生素。Azithromycin )是新一代大环内酯类抗菌药物，组织穿透力强，