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[摘要]
目的 分析海口市妇幼保健院儿科抗菌药不良反应(ADR)发生的临床特点,为儿童的合理用药提供理论依据。方法 对本院2014年1月-2019年12月上报的326例使用抗菌药发生ADR的儿童病历进行统计分析。结果 326例ADR报告中,男189例,女137例,其中年龄<1岁132例(40.49%),1 ≤年龄<3岁的108例(33.13%),3 ≤年龄<6岁的61例(18.71%),6 ≤年龄<14岁的25例(7.67%);ADR发生时间在>用药后48 h的195例(59.82%),≤用药后48 h的87例(26.69%),≤用药后24 h的44例(13.50%);用药途径中iv 215例(65.95%),口服药物70例(21.47%),im 29例(8.90%);原发病中支气管肺炎120例(36.81%)和支气管炎66例(20.25%),消化道感染50例(15.34%);临床表现最多为消化系统表现,有116例(35.58%),其次皮肤及附件表现,有88例(26.99%),呼吸系统表现43例(13.19%);发生不良反应的抗菌药最多的头孢霉素有136例(41.72%),其次是大环内酯类90例(27.61%),青霉素类有76例(23.31%)。结论 本院儿科抗菌药ADR发生以男性患儿为主,多发生于3岁以下的儿童,常在用药48 h后发生,iv多见,原发病以呼吸系统疾病为主,消化系统损害为ADR的主要表现,发生药物以头孢霉素最多,在临床上应合理地使用抗菌药物,保证儿童的用药安全。
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[Abstract]
Objective To analyze the clinical characteristics of adverse drug reaction (ADR) of antibacterial in pediatrics in Haikou Hospital of the Maternity and Child Health, and to provide theoretical basis for children's drug use. Methods A total of 326 ADR cases of children in Haikou Hospital of the Maternity and Child Health from January 2014-December 2019 were collected and analyzed. Results 326 ADR cases were collected and analyzed, 189 cases of which are men, and 137 cases of which are women; 132 cases (40.49%) of children are one year old, 108 cases (33.13%) of children are 1-3 years old, 61 cases (18.71%) of children are 4-6 years old, and 25 cases (7.67%) of children are aged 7-14 years old. There were 195 cases (59.82%) children with ADR occurrence time >48 h; 87 cases (26.69%) children with ADR occurrence time ≤ 48 hours, and 44 cases (13.50%) children with ADR occurrence time ≤ 24 h. Medication pathway:215 cases (65.95%) children were administrated by intravenous, 70 cases (21.47%) children were administrated by oral use, 29 cases (8.90%) children were administrated by intramuscular injection. Original incidence:120 cases (36.81%) children were diagnosed with bronchial pneumonia, 66 cases (20.25%) children were diagnosed with bronchitis, 50 cases (15.34%) children were diagnosed with gastrointestinal infection. The highest clinical performance was 116 cases (35.58%) of digestive system performance, followed by skin and attachment performance of 88 cases (26.99%) and respiratory performance of 43 cases (13.19%). 136 cases (41.72%) ADR were induced by cephalosporine, followed 90 cases (27.61%) ADR were induced by cyclosyl esters, and 76 cases (23.31%) ADR were induced by penicillin. Conclusion ADR occurs mainly in male children, mostly in children under 3 years of age, often occurs at 48 h after administration. Intrtravenous injection is more common medication pathway which induced ADR. The original incidence of children is mainly respiratory disease, and digestive damages are the main manifestation of ADR. The occurrence of ADR are most induced by cephalosporines. Limiting the use of antibiotics and reducing drug administrated by intravenous, ADR had significantly decreased. Clinical use antibiotics should be reasonable to ensure the safety of children's medication.
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R978.1
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