不同抗生素治疗新生儿肺炎的疗效与安全性观察

目的 观察不同抗生素治疗新生儿肺炎的疗效、对肠道微生态的影响及不良反应.方法回顾性分析128例新生儿肺炎患儿为研究对象,根据使用抗生素不同分为哌拉西林舒巴坦组（单药1组）、头孢哌酮舒巴坦组（单药2组）、哌拉西林舒巴坦＋阿奇霉素组（联合1组）、头孢哌酮舒巴坦＋阿奇霉素组（联合2组）.以各项观察项目全部正常的时间作为肺炎病程终止时间,比较各观察组的治愈率并进行时间-效应分析.分析使用抗生素3、7 d时肠道菌群中细菌的含量.结果 各组的治愈率及时间-效应分析差异无统计学意义（P ＞ 0.05）;各抗生素使用组对肠道菌群均有影响,随抗生素使用时间的增加而增大;各组对双歧杆菌的影响力以联合1组及联合2组较大.结论 治疗新生儿感染性肺炎,青霉素类抗生素的疗效不差于头孢类,仍值得推广应用.联合用药疗效并不优于单用青霉素,且抗生素使用种类越多、用药时间越长,对肠道微生态的影响越大.

Observation of the efficacy and safety of different antibiotic in the treatment of neonatal pneumonia

Objective To observe the efficacy, gut microflora and adverse reactions of different antibiotics in the treatment of neonatal pneumonia. Methods A retrospective analysis of 128 cases of neonates with pneumonia as the research object, according to the use of antibiotics who were divided into piperacillin sulbactam group （group 1）, cef- operazone sulbactam group （group 2） piperacillin sulbactam combined azithromycin group （combined 1 group）,cefop- erazone sulbactam combined azithromycin group （combined 2 group）. All of the clinical manifestations returned to normal was terminated as pneumonia course of time, compared the cure rate of the observation group and time-effect analysis. Analyze the content of intestinal flora in the use of antibiotics 3,7 d. Results The cure rate of each group and time-effect analysis showed that the differences were not significant（P 〉 0.05） ;Intestinal flora was affected in an- tibiotic-used groups, and with the time increasing of the use of antibiotics; and the influence on bifidobacterium of each group was obvious in combined 1 group and combined 2 group. Conclusion The treatment of neonatal infectious pneumonia,the efficacy of penicillin antibiotics not worse than the cephalosporins＇,which is still worthy of populariza- tion and application. The efficacy of combination therapy was not superior with penicillin, the more types, the longer the medication in the use of antibiotics, the greater the impact on the gut microflora.