儿童肺炎支原体肺炎临床用药分析

目的分析儿童肺炎支原体肺炎(MPP)临床药物使用情况。方法104例MPP患儿,对患儿的性别、年龄、发热时间、血白细胞、C反应蛋白(CRP)、影像学改变等临床资料进行统计分析。分析患儿药物使用情况,比较重症MPP和普通MPP患儿临床用药(使用阿奇霉素、使用糖皮质激素、联用头孢类抗生素、联用青霉素类抗生素)、痰培养阳性及合并症(合并胸腔积液、合并肺不张/实变)情况。结果104例住院患儿中,103例使用阿奇霉素,使用时间为1~20 d,其中仅2例口服阿奇霉素,24例先门诊口服后住院改静脉注射,77例住院期间静脉使用阿奇霉素,出院后阿奇霉素口服序贯治疗。51例患儿联合使用头孢类抗生素进行抗感染治疗,39例患儿联合使用青霉素类抗生素,36例联合联合使用糖皮质激素。重症MPP与普通MPP患儿使用阿奇霉素、联用头孢类抗生素、联用青霉素类抗生素、痰培养阳性、合并胸腔积液的占比比较差异均无统计学意义(P>0.05);重症MPP患儿使用糖皮质激素占比81.82%(9/11)、合并肺不张/实变占比81.82%(9/11)均高于普通MPP患儿的29.03%(27/93)、35.48%(33/93),差异具有统计学意义(P<0.05)。结论MPP治疗以阿奇霉素为主,住院治疗以静脉使用阿奇霉素为主,重症MPP合并肺不张/实变者多,糖皮质激素使用更多。

Analysis of clinical medication of children with Mycoplasma pneumoniae pneumonia

Objective To analyze the use of clinical drugs for severe Mycoplasma pneumoniae pneumonia(MPP)in children.Methods The clinical data of 104 children with MPP,such as gender,age,fever time,white blood cells,C-reactive protein(CRP),and imaging changes were statistically analyzed.The drug use in children was analyzed.The clinical medication(using azithromycin,combined use of cephalosporin antibiotics,combined use of penicillin antibiotics),sputum culture positive and complications(combined with pleural effusion,combined with atelectasis/consolidation)of severe MPP and common MPP were compared.Results Among 104 hospitalized children,103 cases were treated with azithromycin for 1-20 d,of which only 2 cases were treated with azithromycin orally,24 cases were treated with azithromycin orally in outpatient department first and then intravenous injection in hospital,77 cases were treated with azithromycin intravenously during hospitalization,and azithromycin was treated with oral sequential therapy after discharge.51 children were treated with cephalosporin antibiotics for anti-infection,39 children were treated with penicillin antibiotics,and 36 were treated with glucocorticoids.There was no statistically significant difference in the proportion of using azithromycin,combined use of cephalosporin antibiotics,combined use of penicillin antibiotics,positive sputum culture,and combined pleural effusion between severe MPP and common MPP children(P>0.05).The proportion of glucocorticoids and 81.82%(9/11)and combined with atelectasis/consolidation of severe MPP children were 81.82%and 81.82%(9/11),which were all higher than 29.03%(27/93)and 35.48%(33/93)of common MPP children,and the difference was statistically significant(P<0.05).Conclusion The main treatment for MPP is azithromycin,and the main treatment for hospitalization is intravenous azithromycin.There are more patients with severe MPP with atelectasis/consolidation,and more glucocorticoids are used.