儿科病房抗生素相关性腹泻的临床观察

目的 观察儿科病房抗生素相关性腹泻（antibiotic associated diarrhea，AAD）的临床表现。方法 对983例使用抗生素的患儿进行分析，根据是否发生AAD分为两组，AAD组共有76例患儿，未发生AAD的对照组有907例患儿。分析AAD组患儿使用抗生素的情况，并对两组患儿的基本情况进行比较分析。结果 对AAD患儿抗生素使用种类进行分析，发现导致AAD的抗生素主要有三类，其中美洛西林/舒巴坦使用率最高，为18.4%，其次为美洛西林、头孢哌酮/舒巴坦和阿奇霉素，均为14.5%。并且，AAD的发生与性别无关（P>0.05）。但是AAD在体重较轻、低龄、抗生素使用时间较长和抗生素联用患儿中多发（P<0.05）。这些因素均会导致患儿住院时间延长并出现重要器官损伤现象。结论 儿科病房中抗生素的使用要合理科学，尽量减少AAD的发生。

Clinical observation on antibiotic-associated diarrhea in pediatric wards

Abstract: Objective To observe the clinical manifestations of antibiotic-associated diarrhea (AAD) in pediatric wards. Methods 983 children who were given antibiotics were divided into the AAD group (n=76) or control group (n=907) according to whether they occurred AAD. The use of antibiotics in AAD group was analyzed, and a comparison between the two groups was performed. Results Most of the AAD cases were caused by three categories of antibiotics, including Cephalosporins, Penicillins and Macrolides. Among them, the usage rate of Mezlocillin/Sulbactam was the highest (18.4%), followed by Mezlocillin (14.5%), Cefoperazone/Sulbactam (14.5%) and Azithromycin (14.5%). The incidence of AAD had nothing to do with gender (P>0.05), but with lower weight, younger age, long-term use of antibiotics and combination use of antibiotics (Ps<0.05). These factors led to prolonged hospitalization and significant organ damage. Conclusion The use of antibiotics in pediatric wards should be rational and reasonable to minimize the incidence of AAD.