早产儿预防应用抗菌药物指征探讨

目的：探讨住院早产儿预防应用抗菌药物指征,使早产儿预防应用抗菌药物更规范,避免抗菌药物滥用。方法：选择2011年1月至2012年12月广东省东莞市石排医院新生儿科住院的早产儿,其中2011年收治早产儿136例设为对照组,为普遍预防应用抗菌药物组;2012年收治早产儿150例设为观察组,为严格按用药指征预防应用抗菌药物组。分别调查2011年、2012年住院早产儿抗菌药物使用率、不良反应发生率、实际发生感染率、医院感染发生率、人均预防应用抗菌药物费用及人均预防应用抗菌药物时间。结果：观察组预防应用抗菌药物使用率28.7%,对照组预防应用抗菌药物使用率70.5%,两组比较差异有统计学意义（P〈0.05）。对照组实际感染发生率11.0%,观察照组实际感染发生率8.0%,两组比较差异无统计学意义（χ2=0.77,P〉0.05）;观察组院内感染发生率5.3%,对照组发生率12.5%,两组比较差异有统计学意义（χ2=4.37,P〈0.05）。两组患儿人均预防应用抗菌药物费用、人均预防应用抗菌药物时间比较差异有统计学意义（t分别20.92、20.78,P〈0.01）。对照组不良反应发生率21.3%,观察组不良反应发生率12.0%,两组比较差异有统计学意义（χ2=5.27,P〈0.01）。结论：严格掌握早产儿预防应用抗菌药物指征,可减少实际感染发生率,同时降低院内感染发生率及抗菌药物不良反应发生率,降低使用抗菌药物费用,减轻了患儿家长的经济负担。

Research on the Indications of Prophylactic Use of Antibiotics in Premature Infants

Objective ： To explore the indications of prophylactic use of antibiotics in premature infants during their hospitalization, and to avoid abuse of antibiotics. Methods： Hospitalized preterm infants in our hospital from January 2011 to December 2012 were selected. One hundred and thirty-six premature infants in our hospital in 2011 were set as the control group, and received general preventive antibiotics. One hundred and fifty in 2012 were set as the observation group, and received antibiotic prophylaxis under strict indications. The antibiotics utilization ratio, the incidence of adverse reactions, the infection rate, the incidence of nosocomial infection, and the per capita cost and course of prophylactic use of antibiotics were investigated. Results： The antibiotics utilization ratio in the observation group was 28.7% , and in the control group was70.5% ; there was a significant difference between the two groups （P〈0.05）. The infection rate in the control group and the observation group was 11.0% and 8.0% , respectively; there was no difference （X2= 0.77, P〉0.05 ）. The incidence of nosocomial infection in the observation group and the control group was 5.3% and 12.5% , respectively; there was a difference （X2 =4.37, P〈0.05）. The per capita cost and course of prophylactic use of antibiotics between the two groups were statistically different （t=20.92, t=20.78, P〈0.01 ）. The incidence of adverse reaction in the control group and the observation group was 21.3% and 12.0% ; the difference was statistically significant （X2 =5.27, P〈0.01 ）. Conclusions： To grasp the indications of prophylactic use of antibiotics in premature infants strictly may decrease the incidences of infection, nosocomial infection, adverse reactions and the per capita cost of antibacterial drugs.