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目的评估应用C-反应蛋白(CRP)作为抗生素治疗新生儿细菌感染唯一停药指标的安全性。方法符合病例入选标准的159例新生儿根据出生后检测的CRP值分为:无感染组和感染组。感染组又分为CRP指导组和7天治疗组、CRP指导组根据每天测得的CRP做为停用抗生素的指标;7天治疗组应用抗生素至少7天,待临床症状消失和CRP<10mg/L后停药。结果无感染组2例(1.2%),感染组无病人需再次接受抗生素治疗。CRP<10mg/L者159例中有156例(98.8%)不必再次应用抗生素;抗生素疗程:无感染组为3d;CRP指导组为4~11d,平均(4.7±0.9)d;7天治疗组为7~14d,平均(9.4±1.7)d;无感染组与CRP指导组、CRP指导组与7天治疗组之间在抗生素应用天数方面差异有显著性(P<0.01);而再感染发生率差异无显著性(P>0.05)。结论CRP可作为新生儿细菌感染停用抗生素的安全有效的标准,可以明显缩短抗生素疗程,而不增加感染复发率。
Objective To assess the safety of using C-reactive protein (CRP) as the only antidote to neonatal bacterial infections as an antibiotic. Methods A total of 159 newborns who met the inclusion criteria were divided into non-infected group and infected group according to CRP after birth. The infection group was divided into CRP guidance group and 7-day treatment group. The CRP guidance group used the daily CRP as an indicator of antibiotic withdrawal. Antibiotics were used in the 7-day treatment group for at least 7 days until the clinical symptoms disappeared and CRP <10 mg / L after stopping. Results No infection in 2 cases (1.2%), no infection in patients need to be treated again with antibiotics. There were 156 cases (98.8%) of 159 cases with CRP <10 mg / L, and no antibiotics were required. Antibiotic treatment: no infection group was 3 days; CRP group was 4 ~ 11 days with an average of 4.7 ± 0.9 days; (P <0.01). However, there was a significant difference (P <0.01) between antibiotic-treated days and no-infected group and CRP-guided group The difference was not significant (P> 0.05). Conclusions CRP can be regarded as a safe and effective standard for discontinuing antibiotics in neonatal bacterial infection, which can significantly shorten the course of antibiotics without increasing the recurrence rate.