| 厄他培南在急诊儿童抗感染治疗中的应用研究 |
| 投稿时间：2025-02-17 修订日期：2025-03-23 点此下载全文 |
| 引用本文：曲艳凝,段朱岩,盛梦奕,王利利,王亮亮,孙祺,杨盼,郭琳琳,郭琳瑛.厄他培南在急诊儿童抗感染治疗中的应用研究[J].医学研究杂志,2025,54(7):91-95, 144 |
| DOI：
10.11969/j.issn.1673-548X.2025.07.017 |
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| 基金项目:北京市属医学科研院所公益发展改革试点项目(京医研2023-10) |
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| 中文摘要:目的 评估厄他培南在儿科急诊治疗感染性疾病的临床适应证、疗效及安全性,分析其应用指征,为合理用药提供依据。方法 采用回顾性队列研究,纳入2023年1～12月在首都医科大学附属首都儿童医学中心急诊科因细菌感染接受厄他培南治疗的538例患儿。收集患儿基本信息、疾病诊断、感染类型及治疗情况等资料,并利用单因素与多因素Logistic回归分析住院风险相关因素。结果 厄他培南在各年龄段儿童中应用广泛,主要治疗肺炎(25.8%)、化脓性扁桃体炎(18.4%)和支气管炎(14.7%)。部分普通感染患儿因感染表现重、初始抗生素疗效不佳或头孢菌素类过敏而选择厄他培南升级治疗。主要临床应用指征包括头孢类过敏(48.4%)、前期抗生素无效(37.2%)及中重度感染(12.5%)。80.9%的患儿病情改善,退热中位时间2天、炎性指标恢复中位时间4天、总疗程中位时间5天。不良反应发生率为9.5%,主要为轻中度胃肠道反应(腹泻5.2%、恶心呕吐2.2%)。多因素Logistic回归分析显示,肺炎、淋巴结炎、泌尿系感染及基础疾病是儿科急诊感染性疾病住院的独立危险因素。结论 厄他培南在儿科急诊感染性疾病中疗效良好且安全性高,尤其适用于中重度感染、头孢类过敏及前期抗生素治疗无效的患儿。 |
| 中文关键词:厄他培南 儿科急诊 细菌感染 回顾性研究 |
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| Application of Ertapenem in Pediatric Emergency Antimicrobial Therapy. |
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| Abstract:Objective To assess the clinical indications, efficacy, and safety of ertapenem for pediatric emergency infectious diseases, and to analyze factors guiding its use to inform rational medication choices. Methods A retrospective cohort study was performed on 538 pediatric patients with bacterial infections treated with ertapenem in the Emergency Department of the Capital Institute of Pediatrics from January to December 2023. Patient demographics, diagnoses, infection types, and treatment data were collected. Univariate and multivariate logistic regression analyses were used to identify risk factors for hospitalization. Results Ertapenem was broadly applied across all pediatric age groups, primarily for pneumonia (25.8%), suppurative tonsillitis (18.4%), and bronchitis (14.7%). Some patients with relatively common infections switched to ertapenem due to severe clinical presentations, poor response to initial antibiotics, or cephalosporin allergy. Key indications included cephalosporin allergy (48.4%), failure of prior antibiotics (37.2%), and moderate to severe infections (12.5%). Overall, 80.9% of patients improved clinically; median time to defervescence was 2days, median time for inflammatory marker normalization was 4days, and median total treatment duration was 5days. The incidence of adverse events was 9.5%, mainly mild to moderate gastrointestinal disturbances (5.2% diarrhea, 2.2% nausea/vomiting). Multivariate analysis identified pneumonia, lymphadenitis, urinary tract infection, and underlying diseases as independent risk factors for hospitalization. Conclusion Ertapenem demonstrates good efficacy and a favorable safety profile in pediatric emergency infectious diseases, particularly for moderate to severe infections, cephalosporin allergy, and cases unresponsive to initial antibiotic therapy. |
| keywords:Ertapenem Pediatric emergency Infectious diseases Retrospective study |
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