酪酸梭菌活菌散与抗菌药间隔序贯应用预防抗生素相关性腹泻疗效观察

目的观察和评价酪酸梭菌活菌散（商品名：宝乐安）与抗菌药间隔序贯应用治疗小儿肺炎预防抗生素相关性腹泻的临床疗效。方法将203例肺炎患儿随机分为预防组和对照组,预防组103例,对照组100例,2组均给予抗菌药及对症支持治疗。其中预防组在治疗的同时间隔2～3 h序贯使用酪酸梭菌活菌散,0.5 g/次,3次/d,出现腹泻继续服用;对照组不用酪酸梭菌活菌散预防,出现腹泻用酪酸梭菌活菌散治疗,0.5 g/次,3次/d。对2组继发腹泻的发生率、腹泻持续天数、肺炎治疗的总疗程、腹痛和脱水等症状和体征进行统计分析。结果预防组继发腹泻12例,发生率为11.7%,对照组继发腹泻57例,发生率为57.0%,2组相比差异具有非常显著性（P〈0.01）;预防组腹泻持续时间和治疗疗程显著短于对照组（P〈0.01）;预防组患儿腹痛和脱水等症状和体征发生率均少于对照组（P〈0.01）。结论酪酸梭菌活菌散与抗菌药间隔序贯应用治疗肺炎,能显著降低小儿抗生素相关性腹泻的发生率,预防性应用具有积极的临床意义。

Clostridium Butyricum powder with antibacterials at regular intervals for preventing antibiotic-associated diarrhea

Objective To observe and evaluate the efficacy of Clostridium Butyricum powder with antibacterials at regular intervals for preventing antibiotic-associated diarrhea.Method 203 infants with pneumonia were randomly divided into two groups,103 infants as observation group,another 100 infants as control group.With normal antibacterial therapy,two hours afterwards Clostridium Butyricum powder was administered at dose of 0.5 g three times a day,in observation group.After diarrhea taken place,Clostridium Butyricum powder was administered at dose of 0.5 g three times a day,in control group.Clinical effect and untoward effect were observed.Result The incidence of antibiotic-associated diarrhea was 11.7% in observation group,and 57% in control group（P〈0.01）.Duration of diarrhea and period of treatment in observation group as compared to those in the control group were statistically significant（P〈0.01）.The symptoms and signs of infants in observation group were lighter than those in the control group（P〈0.01）.Adverse reaction was not found.Conclusion Clostridium Butyricum powder with antibacterial therapy at regular intervals can prevent antibiotic-associated diarrhea after pneumonia with antibacterial therapy at regular intervals.