首页|急性白血病中性粒细胞减少患者应用喹诺酮类药物预防感染的临床研究

急性白血病中性粒细胞减少患者应用喹诺酮类药物预防感染的临床研究

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目的 探索急性白血病中性粒细胞减少患者应用喹诺酮类药物预防感染的临床效果.方法 选取2013年10月~2015年10月期间山东大学第二医院收治的62例急性白血病中性粒细胞减少患者,将患者动态随机化分为2组,对照组和观察组分别采用头孢类药物治疗和喹诺酮类药物治疗,2组患者各有31例.结果 观察组患者实施喹诺酮类药物治疗后,菌群分布情况明显下降,其中以肺炎克雷伯杆菌最为常见,但与对照组相比,仍存在差异性(P<0.05),而观察组患者口腔溃疡感染发生率为9.68%、上呼吸道感染率为6.45%、肺感染率为6.45%、消化道感染率为6.45%、肛周感染率为3.23%、皮肤感染率为3.23%、其他感染率为3.23%,其明显低于对照组患者(P<0.05),同时观察组患者重度中性粒细胞减少持续时间、中性粒细胞减少缺乏程度也明显优于对照组患者(P<0.05).结论 喹诺酮类药物在急性白血病中性粒细胞减少患者中预防效果显著,可降低感染发生率.
Study in acute leukemia neutropenia in patients with the clinical application of quinolones in prevention of infection
Objective To investigate the clinical benefits and the impacts on distribution and antibiotic resistance of pathogenic bacterium associated with fluoroquinolone prophylaxis during neutropenia in patients with acute leukemia.MethodsA total of 62 infection episodes occurred in patients with acute leukemia were retrospectively analyzed from October 2013 to October 2015.The patients admitted in ward A (group A,n=31) received Cephalosporin drugs as contrast, and received quinolones in ward B (group B,n=31).ResultsTo observe the implementation of quinolones in treatment of patients, the bacteria decreased significantly, the Klebsiella pneumoniae was the most common, but compared with the control group, there are still differences (P<0.05, and the observation group of patients with oral ulcer infection rate was 9.68%, upper respiratory tract infection rate was 6.45%, the infection rate of lung 6.45%, the digestive tract infection rate was 6.45%, the infection rate was 3.23%, perianal skin infection rate was 3.23%, the infection rate was 3.23%, which is significantly lower than the control group (P<0.05, and the observation group of patients with severe neutropenia, duration of neutropenia lack degree is significantly better than the control group (P<0.05).ConclusionThe fluoroquinolone prophylaxis induces diminishing proportion of normal flora and increasing frequency of Escherichia coli in severely neutropenic patients with acute leukemia,may not influence the distribution of other bacteria.The susceptility of main pathogens may not be affected by antibiotic prophylaxis.The fluoroquinolone don't decrease the incidence of septicemia and infection in gastrointestinal tract.Our data suggest that more prudent use of antibiotic prophylaxis may be reasonable even in patients at high-risk for developing infection.

leukemianeutropeniaquinolonesinfection

高晓巧、刘庆娜、魏金宝

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山东大学第二医院药学部,山东济南250033

急性白血病 中性粒细胞减少 喹诺酮类药物 预防感染

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.(5)
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