北京地区中耳炎有效抗生素的筛选

发布时间：2018-04-24 01:08

本文选题：中耳炎 + 药物敏感性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年16期

【摘要】：目的:探讨中耳炎预防和控制感染的有效抗生素的筛选,为临床合理使用抗生素奠定理论基础。方法:取198例中耳炎患者的中耳脓性分泌物做细菌培养及药敏试验,根据临床是否常用、是否有耳毒性等因素筛选中耳炎抗感染的一线和二线药,并总结用药的疗效。结果:198例中21例无普通细菌生长;177株中最常见的致病菌是凝固酶阴性葡萄球菌36株(20.34%)(利奈唑胺、万古霉素、头孢呋辛、左氧氟沙星、复方新诺明、利福平等敏感),铜绿假单胞菌30株(16.95%)(美洛培南、亚胺培南、头孢他啶、阿米卡星、哌拉西林等敏感),金黄色葡萄球菌26株(14.69%)(利奈唑烷、万古霉素、苯唑西林、庆大霉素、左旋氧氟沙星、环丙沙星、莫西沙星等敏感)。经验性用药:局部用左氧氟沙星滴耳液,哌拉西林、莫西沙星(成人)作为一线药,二线头孢他定。术后有3例感染,经全身、局部敏感药物和换药痊愈。结论:根据细菌培养和药敏试验合理筛选有效抗生素有利于减少中耳炎术后感染并发症。
[Abstract]:Objective: to investigate the screening of effective antibiotics for the prevention and control of infection in otitis media, so as to lay a theoretical foundation for the rational use of antibiotics in clinic. Methods: bacterial culture and drug sensitivity test were performed in 198 cases of otitis media patients with otitis media. According to the factors such as clinical use and ototoxicity, the first-line and second-line anti-infective drugs of otitis media were screened and the curative effect was summarized. Results the most common pathogenic bacteria were coagulase-negative staphylococci (36 strains, 20.34C) in 21 out of 198 cases (levoofloxacin, vancomycin, cefuroxime, levofloxacin, compound sulfamethoxine). Rifampicin and other sensitive strains, 30 strains of Pseudomonas aeruginosa (melopenem, imipenem, ceftazidime, amikacin, piperacillin, etc.), 26 strains of Staphylococcus aureus (Linetazolane, vancomycin, oxacillin, gentamicin, etc.) Levofloxacin, ciprofloxacin, moxifloxacin and other sensitive. Empirical drug: topical levofloxacin ear drops, piperacillin, moxifloxacin (adult) as the first drug, second line ceftazidine. There were 3 cases of infection after operation, which were cured by whole body, local sensitive drugs and dressing change. Conclusion: reasonable screening of effective antibiotics based on bacterial culture and drug sensitivity test is helpful to reduce postoperative infection complications of otitis media.
【作者单位】：中国人民解放军总医院耳鼻咽喉头颈外科;兰大二院定西市人民医院耳鼻喉科;苏州大学附属第一医院耳鼻咽喉头颈外科;
【基金】：北京市科技计划首都市民健康项目培育基金(No:Z131100004013019) 解放军总医院临床科研扶持基金课题(No:2012FC-TSYS-4017) 中国博士后基金(No:2014M552649)
【分类号】：R764.21

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