抗菌药物继发真菌感染46例临床调查与分析.docx

抗菌药物继发真菌感染46例临床调查与分析中国新药杂志 2000年第9期第9卷 调查与分析作者：姜光霞　鲁云兰　李忠芬单位：北京医科大学第一医院药剂科, 北京 100034关键词：抗菌药物；真菌感染；合理用药　　［摘要］目的：提醒医务人员在使用抗菌药物抗感染过程中应严格遵循抗菌药物的使用原则, 合理选择与应用。方法:以1998年出院(包括死亡)患者为对象,回顾性调查抗菌药物继发真菌感染的情况。结果:继发真菌感染者共计72例, 其中抗菌药物继发者46例。多发于60岁以上的老年患者(50%); 出现感染的时间多在用药后3周之内(52.2%); 好发部位为肠道、呼吸道和泌尿道。2种以上抗菌药物联用继发感染的机率高，共52例次，占77.6%。仅1种药物继发真菌感染的12例患者中, 第三代头孢菌素10例, 其中6例为头孢曲松。就46例患者使用的抗菌药物而言,仍然是第三代头孢菌素使用率最高(48例次)。结论:抗菌药物尤其是第三代头孢菌素的滥用是继发真菌感染的重要因素, 提高合理用药水平是减少院内二重感染的关键。　　［中图分类号］R978　　［文献标识码］C　　［文章编号］1003-3734(2000)09-0653-04Clinical investigation and analysis of 46 cases of secondary　　fungal infections following antibiotic therapyJIANG Guang-xia　LU Yun-lan　LI Zhong-fen　　（The First Teaching Hospital,Beijing Medical University,Beijing 100034,China）　　［Abstract］Objective:To alert medical professionals that the basic principals in rational selection and use of antibiotics should be strictly abided by.Methods:In the retrospective study,patients discharged from the hospital in 1988 including death were investigated for secondary fungal infections following antibiotics therapy.Results:There were 72 cases of secondary fungal infections in total and 46 had been occurred after antibiotic therapy.Most of them occurred in elderly of over sixty(50%)and within 3 weeks of antibiotic therapy(52.2%);the predilection sites were intestinal,respiratory and urinary tracts;much more secondary infections occurred in combined antibiotics therapy(77.6%).12 cases were occurred in single antibiotic therapy,10 of them were treated with cephlosporins of the third generation and among them 6 were cefatriaxone.Of the 46 secondary fungal infections,48 case-time were occurred to cepholosporins of the third generation.Conclusion:Abuse of antibiotics,especially the third generation cephalosporins,was the cause of secondary fungal infections,therefore rational use of antibiotics is the key for decrease secondary fungal infections in hospitals.　　［Key words］　antibiotics; mycotic infection;rational administration　　近年来随着抗菌药物