老年社区获得性肺炎临床特点及抗生素应用体会.docVIP

精品论文 参考文献 老年社区获得性肺炎临床特点及抗生素应用体会 江苏省苏州工业园区车坊医院 丁虹 215125 【摘要】目的 探讨老年社区获得性肺炎的临床特点以及临床抗生素的使用体会。方法 选取68例于2012年5月至2013年5月期间我院接收的老年CAP患者，患者均进行细菌培养试验和药物敏感性鉴定，观察老年社区获得性肺炎的临床特点及抗生素治疗疗效。结果 本组68例患者共分离出56棵菌株，其中革兰阳性球菌共24棵（42.9%），革兰阴性杆菌共30棵（53.6%），真菌共2棵（3.6%），肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌对环丙沙星、亚胺培南的药敏性高，金黄葡萄球菌、肺炎链球菌对左氧氟沙星、亚胺培南、头孢曲松以及万古霉素的药敏性高。经过抗生素治疗，其中治愈46例，显效及有效16例，临床总有效率为91.2%，无效6例，死亡3例，死亡率4.4%。结论 老年社区获得性肺炎以革兰阴性菌为主，在抗生素选择上，给予环丙沙星或亚胺培南治疗，若考虑为革兰阳性球菌，可首选万古霉素或左氧氟沙星治疗，从而提高疗效。 【关键词】抗生素；老年CAP的临床特点 Elderly community-acquired pneumonia clinical features and antibiotic Experience Abstract Objective To investigate the elderly community-acquired pneumonia clinical characteristics and clinical experience of the use of antibiotics. Methods 68 cases in the period from May 2012 to May 2013, I received CAP elderly hospital patients, patients underwent bacterial culture and drug sensitivity tests to identify, observe the elderly community-acquired pneumonia clinical features and antibiotic therapy. The results in this group of 68 patients, 56 strains were isolated, including Gram-positive cocci Total 24 (42.9%), Gram-negative bacilli Total 30 (53.6%), a total of two fungi (3.6%), Klebsiella pneumoniae Peter bacteria, Pseudomonas aeruginosa, Escherichia coli to ciprofloxacin, imipenem susceptibility is high, Staphylococcus aureus, Streptococcus pneumoniae to levofloxacin, imipenem, ceftriaxone and vancomycin high susceptibility factors. After antibiotic treatment, which cured 46 cases, 16 cases were cured and effective clinical total effective rate was 91.2%, 6 cases, 3 cases of death, the mortality rate of 4.4%. Conclusions Elderly community-acquired pneumonia in Gram-negative bacteria, the antibiotic of choice, given ciprofloxacin or imipenem treatment, if considered as Gram-positive cocci, may be the preferred treatment of vancomycin or levofloxacin, thereby improving efficacy. Key words antibiotics; clinical characteristics of elderly CAP 社区获得性肺炎（CAP）是临床内科常见疾病，好发于老年人，是指医院外罹患的感