[1]张忠刚,王 洪,孙 敬.儿科住院患者与抗生素相关的不良药物反应发生率及危险因素分析[J].医学信息,2021,34(20):108-111.[doi:10.3969/j.issn.1006-1959.2021.20.027]
　ZHANG Zhong-gang,WANG Hong,SUN Jing.Analysis of the Incidence and Risk Factors of Antibiotic-related Adverse Drug Reactionsin Hospitalized Pediatric Patients[J].Medical Information,2021,34(20):108-111.[doi:10.3969/j.issn.1006-1959.2021.20.027]
点击复制

儿科住院患者与抗生素相关的不良药物反应发生率及危险因素分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年20期
页码:
108-111
栏目:
论著
出版日期:
2021-10-20

文章信息/Info

Title:
Analysis of the Incidence and Risk Factors of Antibiotic-related Adverse Drug Reactionsin Hospitalized Pediatric Patients
文章编号:
1006-1959（2021）20-0108-04
作者:
张忠刚1; 王 洪2; 孙 敬1
青海省妇女儿童医院急诊科1，消化科2，青海 西宁 810007
Author(s):
ZHANG Zhong-gang1; WANG Hong2; SUN Jing1
Emergency Department1,Digestive Department2,Qinghai Women’s and Children’s Hospital,Xining 810007,Qinghai,China
关键词:
住院儿科患者; 抗生素; 药物不良反应
Keywords:
Hospitalized pediatric patients; Antibiotics; Adverse drug reactions
分类号:
R969.3
DOI:
10.3969/j.issn.1006-1959.2021.20.027
文献标志码:
A
摘要:
目的 分析儿科住院患者中与抗生素相关的不良药物反应（ADR）发生率和危险因素。方法 选取2018年1月-2020年1月于我院住院治疗的儿童患者359例为研究对象，研究抗生素相关ADR发生率及严重程度，分析ADR的危险因素。结果 住院儿童患者抗生素类药物使用中青霉素（64.07%），头孢菌素（55.99%）和大环内酯类（18.11%）最常见。ADR的发生率为16.43%，6例轻度（10.17%），中度45例（76.27%），重度8例（13.56%）。与头孢曲松、阿奇霉素和青霉素有关的ADR较为常见，分别有24例（40.68%）、13例（22.03%）、10例（16.95%）。ADR影响最多的器官系统是胃肠道45例（76.27%）和皮肤14例（23.73%）；多因素Logistics回归分析结果显示，年龄＜2岁、过敏史/ADR史、合并症、抗生素使用种类≥3种、住院时间≥5 d为ADR的独立危险因素（P＜0.05）。结论 儿童住院患者大多数抗生素相关ADR为轻中度，错误处方和错误检测是可避免ADR发生的主要原因，监测儿童中抗生素的使用对于确保这些患者的安全至关重要。
Abstract:
Objective To analyze the incidence and risk factors of antibiotic-related adverse drug reactions (ADR) in hospitalized pediatric patients.Methods A total of 359 children hospitalized in our hospital from January 2018 to January 2020 were selected as subjects to study the incidence and severity of antibiotic-related ADR and analyze the risk factors of ADR.Results The most common use of antibiotics in hospitalized children was penicillin (64.07%), cephalosporins (55.99%) and macrolides (18.11%). The incidence of ADR was 16.43%, 6 cases were mild (10.17%), 45 cases (76.27%) were moderate, and 8 cases (13.56%) were severe. ADRs related to ceftriaxone, azithromycin and penicillin were more common, with 24 cases (40.68%), 13 cases (22.03%), and 10 cases (16.95%) respectively. The organ systems most affected by ADR were the gastrointestinal tract in 45 cases (76.27%) and the skin in 14 cases (23.73%). Multivariate logistic regression analysis showed that age<2 years old, history of allergy/ADR, comorbidities, types of antibiotics ≥3, hospital stay ≥5 days were independent risk factors for ADR (P<0.05).Conclusion Most of the antibiotic-related ADRs in hospitalized children are mild to moderate. Wrong prescription and wrong detection are the main reasons of avoidable ADR. Monitoring the use of antibiotics in children is very important to ensure the safety of these patients.

参考文献/References:

[1]Saqib A,Sarwar MR,Sarfraz M,et al.Causality and preventability assessment of adverse drug events of antibiotics among inpatients having different lengths of hospital stay: a multicenter, cross-sectional study in Lahore, Pakistan[J].BMC Pharmacol Toxicol,2018,19(1):34.[2]Smyth RM,Gargon E,Kirkham J,et al.Adverse drug reactions in children-a systematic review[J].PLoS One,2012,7(3):e24061.[3]谢新鑫,杨青廷,旷满华,等.2004~2015年中国儿童抗生素使用情况分析[J].中南医学科学杂志,2016,44(2):130-134.[4]Barbieri E,Donà D,Cantarutti A,et al.Antibiotic prescriptions in acute otitis media and pharyngitis in Italian pediatric outpatients[J].Ital J Pediatr,2019,45(1):1-9.[5]Beck JN,Suppes SL,Smith CR,et al.Cost and potential avoidability of antibiotic-associated adverse drug reactions in children[J].J Pediatric Infect Dis Soc,2017,8(1):66-68.[6]Vieira JML,Matos GC,Silva FAB,et al.Serious adverse drug reactions and safety signals in children: a nationwide database study[J].Front Pharmacol,2020,11(2):964.[7]Alqenae FA,Steinke D,Keers RN.Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review[J].Drug Safety,2020,43(2):155-161.[8]McDonnell PJ,Jacobs MR.Hospital admissions resulting from preventable adverse drug reactions[J].Ann Pharmacother,2002,36(9):1331-1336.[9]Shoushtari AN,Friedman CF,Navid-Azarbaijani P,et al.Measuring Toxic Effects and Time to Treatment Failure for Nivolumab Plus Ipilimumab in Melanoma[J].JAMA Oncol,2018,4(1):98-101.[10]Gomm W,von Holt K,Thomé F,et al.Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis[J].JAMA Neurol,2016,73(4):410-416.[11]Brusselaers N,Lagergren J.The Charlson Comorbidity Index in Registry-based Research[J].Methods Inf Med,2017,56(5):401-406.[12]Gallagher RM,Kirkham JJ,Mason JR,et al.Development and inter-rater reliability of the liverpool adverse drug reaction causality assessment tool[J].PLoS One,2011,6(12):e28096.[13]Bracken LE,Nunn AJ,Kirkham JJ,et al.Development of the liverpool adverse drug reaction avoidability assessment tool[J].PLoS One,2017,12(1):e0169393.[14]Hartwig SC,Siegel J,Schneider PJ.Preventability and severity assessment in reporting adverse drug reactions[J].Am J Hosp Pharm,1992,49(9):2229-2232.[15]Dedefo MG,Mitike AH,Angamo MT.Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia[J].BMC Pediatr,2016,16(1):81.[16]马俊华.儿科临床上常见的不良药物反应及原因分析[J].中国现代药物应用,2013,7(9):118-119.[17]Amelung S.Association of preventable adverse drug events with inpatients’length of stay-A propensity-matched cohort study[J].Int J Clin Pract,2017,71(10).[18]王新宇,张艳仙,蒋睿,等.药物不良反应1055份报告分析[J].临床合理用药杂志,2021,14(7):141-142.[19]Saqib A,Sarwar MR,Sarfraz M,et al.Causality and preventability assessment of adverse drug events of antibiotics among inpatients having different lengths of hospital stay: a multicenter, cross-sectional study in Lahore,Pakistan[J].BMC Pharmacol Toxicol,2018,19(1):34.

相似文献/References:

[1]吴君华,吴友茹,李 丹.血清降钙素原在AECOPD抗感染治疗中的应用价值研究[J].医学信息,2018,31(02):74.[doi:10.3969/j.issn.1006-1959.2018.02.025]
　WU Jun-hua,WU You-ru,LI Dan.Study on the Application Value of Serum Calcitonin in the Anti Infection Treatment of AECOPD[J].Medical Information,2018,31(20):74.[doi:10.3969/j.issn.1006-1959.2018.02.025]
[2]王晋蜀,黄梦雅,赵明丹,等.泌尿生殖道支原体感染检测、鉴定及耐药性分析[J].医学信息,2018,31(16):98.[doi:10.3969/j.issn.1006-1959.2018.16.029]
　WANG Jin-shu,HUANG Meng-ya,ZHAO Ming-dan,et al.Detection,Identification and Drug Resistance Analysis of Urogenital Mycoplasma Infection[J].Medical Information,2018,31(20):98.[doi:10.3969/j.issn.1006-1959.2018.16.029]
[3]于文清.下呼吸道感染病原菌分布及耐药性分析[J].医学信息,2018,31(24):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
　YU Wen-qing.Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Lower Respiratory Tract Infection[J].Medical Information,2018,31(20):74.[doi:10.3969/j.issn.1006-1959.2018.24.019]
[4]张佳佳,李 庆,王 同.中性粒细胞CD64指数指导慢性阻塞性肺疾病急性加重期抗生素应用的探讨[J].医学信息,2019,32(07):78.[doi:10.3969/j.issn.1006-1959.2019.07.023]
　ZHANG Jia-jia,LI Qing,WANG Tong.The Application of Neutrophil CD64 Index in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Medical Information,2019,32(20):78.[doi:10.3969/j.issn.1006-1959.2019.07.023]
[5]叶志萍,宋 娇,荣 丹.抗宫炎胶囊联合抗生素对慢性宫颈炎患者的疗效及对T淋巴细胞亚群水平的影响[J].医学信息,2022,35(15):95.[doi:10.3969/j.issn.1006-1959.2022.15.021]
　YE Zhi-ping,SONG Jiao,RONG Dan.Effect of Kanggongyan Capsule Combined with Antibiotics on T Lymphocyte Subsets in Patients with Chronic Cervicitis[J].Medical Information,2022,35(20):95.[doi:10.3969/j.issn.1006-1959.2022.15.021]
[6]宣恒报,成玉春,杨士军.医院感染的耐药菌分布特点与药物应用[J].医学信息,2019,32(22):114.[doi:10.3969/j.issn.1006-1959.2019.22.037]
　XUAN Heng-bao,CHENG Yu-chun,YANG Shi-jun.Distribution Characteristics and Drug Application of Drug-resistant Bacteria in Nosocomial Infection[J].Medical Information,2019,32(20):114.[doi:10.3969/j.issn.1006-1959.2019.22.037]
[7]赵 培.抗生素降阶梯方案治疗小儿重症肺炎的有效性与安全性分析[J].医学信息,2020,33(03):146.[doi:10.3969/j.issn.1006-1959.2020.03.047]
　ZHAO Pei.Effect of Antibiotic Step-down Protocol on Children with Severe Pneumonia[J].Medical Information,2020,33(20):146.[doi:10.3969/j.issn.1006-1959.2020.03.047]
[8]杨昌妮,李 宇,李晓芳,等.老年社区获得性肺炎诊治报道1例并文献复习[J].医学信息,2020,33(17):188.[doi:10.3969/j.issn.1006-1959.2020.17.059]
[9]邓智心,袁 莹,邹志玲,等.不孕症患者慢性子宫内膜炎的诊疗[J].医学信息,2021,34(11):31.[doi:10.3969/j.issn.1006-1959.2021.11.010]
　DENG Zhi-xin,YUAN Ying,ZOU Zhi-ling,et al.Diagnosis and Treatment of Chronic Endometritis in Infertility Patients[J].Medical Information,2021,34(20):31.[doi:10.3969/j.issn.1006-1959.2021.11.010]
[10]周 瑞,张雪芬,张 宁,等.抗生素对早产儿肠道菌群影响的研究[J].医学信息,2023,36(03):177.[doi:10.3969/j.issn.1006-1959.2023.03.039]
　ZHOU Rui,ZHANG Xue-fen,ZHANG Ning,et al.Effect of Antibiotics on Intestinal Microflora in Premature Infants[J].Medical Information,2023,36(20):177.[doi:10.3969/j.issn.1006-1959.2023.03.039]

更新日期/Last Update: 1900-01-01