488例小儿泌尿系感染临床用药分析

目的探讨小儿泌尿系感染的临床用药及致病菌的分布和药敏试验情况,为临床治疗提供依据。方法对1998～2008年首都儿科研究所附属儿童医院肾脏病房收治的488例泌尿系感染患儿的药物治疗及转归进行回顾性分析。结果256例尿培养前未应用过抗生素的患儿其尿培养阳性率为75.39%,232例培养前应用过药物的患儿其阳性率为27.58%,两者差异有统计学意义（P〈0.05）。尿培养结果中大肠埃希菌有174例,对阿莫西林/克拉维酸和头孢西丁的敏感率分别是93.84%和88.36%。结论抗生素的应用会大大降低尿培养的阳性率。大肠埃希菌为泌尿系感染的常见致病菌,治疗时应尽量根据细菌药敏试验结果调整抗生素。在治疗小儿泌尿系感染的时候,阿莫西林/克拉维酸和头孢西丁可作为经验用药。

Clinical Therapy Analysis for 488 Children with Urinary Tract Infection

Objective To discuss the clinical therapy of urinary tract infection, the distribution and antimicrobial sensitivity test of the bacteria so as to provide evidence for clinical treatment. Methods The clinical data of 488 children with urinary tract infection were retrospectively analyzed. Results The urine culture＇s positive rate of the patients who had used antibiotics before the test was higher than those who had not used, 75.39% vs. 27. 58% （P〈0. 05）. Totally 174 Escherichia coli were found in urine culture. The susceptibility of Escherichia coli to Amoxicillin clavulanate and Cefoxitin were 94.12 % and 88.36%. Conclusions The use of antibiotics before urine culture will reduce the positive rate. Escherichia coli is commonly seen in urinary tract infection. Antimicrobial therapy should be initiated under the guidance of antimicrobial sensitivity test if possible. In the treatment of children with urinary tract infection, Amoxicillin clavulanate and Cefoxitin can be used as experience medicines.