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目的考察美罗培南在小儿血液肿瘤感染患者中的疗效。方法2001—2005年对上海交通大学附属上海儿童医学中心血液肿瘤科194例感染患儿回顾性对比美罗培南、亚胺培南/西司他丁和以头孢他啶为代表的三代头孢的体外活性、临床疗效和不良反应。结果除凝固酶阴性的葡萄球菌,美罗培南对血液肿瘤发热患儿最常见的细菌均具有良好的抗菌活性。美罗培南的抗菌谱与亚胺培南相似,但明显优于头孢他啶,其中美罗培南和亚胺培南对噬麦芽寡养单胞菌的敏感性欠佳,而头孢他啶对该菌的敏感性较好,各类抗菌药物体内与体外的敏感度相当,美罗培南较亚胺培南的胃肠道反应少而轻。结论美罗培南是小儿血液肿瘤合并感染时良好的经验性用药选择。
Objective To investigate the efficacy of Meropenem in children with hematological tumor infection. Methods A retrospective study was conducted on the in vitro activities of meropenem, imipenem / cilastatin and third generation cephalosporins represented by ceftazidime in 194 children with hematology and oncology from Shanghai Children’s Medical Center, Shanghai Jiaotong University, 2001-2005. Efficacy and adverse reactions. Results In addition to coagulase-negative Staphylococcus aureus, Meropenem had good antibacterial activity against the most common bacteria in children with fever of hematological tumors. The antibacterial spectrum of meropenem is similar to that of imipenem, but it is obviously better than that of ceftazidime, of which meropenem and imipenem are not sensitive to Stenotrophomonas maltophilia and ceftazidime is more sensitive to this bacterium. , Various types of antimicrobial agents in vitro and in vivo sensitivities are comparable, meropenem less imipenem gastrointestinal reactions than light. Conclusion Meropenem is a good empirical medication choice for children with hematologic malignancies complicated by infection.