摘要
Abstract
OBJECTIVE:To investigate the application of antibiotics in severe acute pancmatitis (SAP) patients in our hospital.METHODS:A total of 276 SAP patients admitted in our hospital from 2005 to 2011 were enrolled to make a survey; their clinical data such as characteristics of infection etiology and resistance monitoring results,varieties selection of antibiotics,dosage and usage and DDDs were respectively analyzed.RESULTS:All of 276 SAP cases were developed secondary infection,and the main infection sites located in pancreas,peripancrea and abdominal cavity.269 infectious bacterial strains were cultivated for bacterial culture and identified from clinical specimens,among which 226 strains (81.9％) including 6 categories were Gram-negative bacilli.The most common infectious pathogens were Gram-negative bacilli and anaerobe,followed by Enterococcus,Staphylococcus and fungi,etc.Clinical application of the third-generation cephalosporins (including compound preparations containing enzyme inhibitors) ranked first place of DDDs list (reaching 10 985); they have become the most widely used to treat SAP patients secondary infection.Detection rates of drug-resistant strains of producing ESBLs and ESBLs gradually increased.Drug resistance rates of 5 kinds of Gram-negative bacilli,such as Escherichia coli,Klebsiella pneumoniae,Enterobacter aerogenes,Enterobacter cloacae nd Acinetobacter baumannii,to ceftazidime were above 70％ ; that of Pseudomonas aeruginosa to ceftazidime were above 50％ ;that of 6 kinds of Gram-negative bacilli to ciprofloxacin were above 60％,but E.coli and K.pneumoniae kept low drug resistance to imipenem,cefoperazone/sulbactam (0-28.3 ％); that of 6 kinds of Gram-negative bacilli to cefoperazone/sulbactam and piperacillin/tazobactam was below 40％,and that of them to imipenem was below 30％.CONCLUSIONS:Both timely and rational use of antibiotics is very important to prognosis for SAP secondary infection patients.It is not only necessary to take into account the drug's ability to penetrate infectious sites tissue,the blood-pancreatic barrier in particular,but also pay attention to the epidemiological characteristics of the relevant pathogens and resistance monitoring results when selecting antibiotics to treat SAP secondary infection.关键词
抗菌药物/重症急性胰腺炎/继发感染Key words
Antibiotics/ Severe acute pancreatitis/ Scondary infection分类
医药卫生
