| 摘要: |
| 目的：了解国内医院儿童血液肿瘤患儿抗菌药物的使用现状，为提高该类疾病抗感染治疗水平提供参考。方法：随机抽取国内两家大型儿童专科医院2018年6月至2019年6月血液肿瘤患儿200例，收集用药信息，包括门诊及住院抗菌药物使用品种、剂量、频率、疗程、联合用药和经验用药情况，并对数据进行统计和分析。结果：门诊和住院患儿抗菌药物使用率分别为21.5%、62.5%，经验用药比例分别为97.7%、81.6%；联合用药比例分别为14.0%、56.0%，最多者为两联用药。住院患儿抗菌药物使用疗程为1~169 d，中位时间为6 d。，在门诊使用最多的抗菌药物是非抗假单胞菌的β-内酰胺类，住院患儿使用最多的为抗真菌药/复方磺胺甲恶唑，其次为碳青霉烯类及糖肽类。治疗方案以初始广覆盖最多，占60.8%。抗菌药物的使用频率不足是最常见的不合理用药类型，其次为剂量不足。结论：目前国内儿童血液肿瘤抗菌药物使用存在经验用药及联合用药比例高、品种不适宜、剂量频率不足、疗程不足或过长、级别过高等问题，尤其是是血液肿瘤粒细胞缺乏并发热的高危患儿，在经验用药方面还存在一定的误区 |
| 关键词: 儿童 血液肿瘤 抗菌药物 现状调查 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2021.07.013 |
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| 基金项目:湖南省卫生健康委员会科研课题,编号20201584 |
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| Investigation on Application of Antibiotics for Children with Hematological Malignancies |
| Zhang Haixia1, Zhang Hao2, Yang Mei2, Zhao Xin1, Zhang Ruidong2, Wang Xiaoling2 |
| (1. Hunan Children’s Hospital, Hunan Changsha 410007, China; 2. Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China) |
| Abstract: |
| Objective: To investigate the current status of application of antibiotics for children with hematological malignancies in domestic hospitals, so as to provide reference for improving the level of anti-infective treatment. Methods: A total of 200 children with hematological malignancies from Jun. 2018 to Jun. 2019 were randomly selected from two large children’s hospitals in China. Medication information was collected, including categories, doses, frequency, course of treatment, drug combination and empirical therapy in outpatients and inpatients, and the data were statistically analyzed. Results: In outpatients and inpatients, the application rate of antibiotics was respectively 21.5% and 62.5%, the proportion of empirical therapy was respectively 97.7% and 81.6%; the proportion of drug combination was respectively 14.0% and 56.0%, and the highest was the combination of two kinds of drugs. The course of treatment of antibiotics in hospitalized children was from 1 to 169 d, with a median of 6 d. The most commonly used antibiotics in outpatients were non-anti-pseudomonas β-lactams, and the most commonly used drugs in hospitalized children were anti-fungal drugs/compound sulfamethoxazole, followed by carbapenems and glycopeptides. Treatment options had the most initial broad coverage, accounting for 60.8%. Insufficient frequency of application of antibiotics was the most common type of irrational medication, followed by insufficient dose. Conclusion: At present, there are some problems in the application of antibiotics for children with hematological malignancies in China, such as high proportion of empirical therapy, drug combination, inappropriate categories, insufficient dose and frequency, insufficient or prolonged course of treatment and high levels, especially for children at high risk of hematological malignancies with granulocytosis and fever, there are still some misunderstandings in the empirical therapy |
| Key words: children hematological malignancies antibiotics investigation on current status |
