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目的 评价环丙沙星治疗小儿重症感染的有效性和安全性。方法 收集北京儿童医院儿童加强医疗病房 (PICU)重症感染患儿 2 6例 ,环丙沙星用量 10～ 2 0mg·kg-1·d-1,静脉给药 ,疗程 4～ 31d (11± 7)d。结果 用药前培养菌对环丙沙星的敏感率为 10 0 %。用药 5天后6例培养出 7株耐药菌 ,耐药菌发生率占 2 3 1% (6 / 2 6 )。其中 4例环丙沙星治疗无效改换敏感抗生素。继发霉菌感染者 4例 ,占 15 4% (4 / 2 6 ) ,2例死于霉菌败血症。本组患儿治愈 11例 ,好转出院 6例 ,无效 9例 ,总有效率为 6 5 4% (17/ 2 6 )。耐药菌株出现和霉菌感染是治疗失败的主要原因。仅 1例患儿治疗过程中出现皮疹 ,副作用发生率为 3 8% (1/ 2 6 )。结论 环丙沙星是治疗儿童严重感染的一种相对安全有效的药物
Objective To evaluate the efficacy and safety of ciprofloxacin in the treatment of severe infections in children. Methods Twenty-six children with severe infection in children’s intensive care unit (PICU) at Beijing Children’s Hospital were enrolled. The dosage of ciprofloxacin was 10 ~ 20 mg · kg-1 · d-1. The patients were treated with intravenous injection for 4 ~ 31 days (11 ± 7) d. Results Before treatment, the sensitivity of the cultured bacteria to ciprofloxacin was 100%. After 5 days of treatment, 6 out of 6 resistant strains were cultivated, and the incidence of resistant bacteria was 23% (6/26). Four cases of ciprofloxacin treatment failed to change sensitive antibiotics. Four cases of secondary fungal infection, accounting for 15 4% (4/26), 2 died of mold septicemia. This group of children cured in 11 cases, 6 cases of improvement and discharge, ineffective in 9 cases, the total effective rate was 65.4% (17/26). The emergence of drug-resistant strains and fungal infection is the main reason for treatment failure. Only one patient had a rash during the course of treatment. The incidence of side effects was 38% (1/26). Conclusion Ciprofloxacin is a relatively safe and effective drug for the treatment of severe infections in children