CAJ | 학술논문

目的：描述因肺炎住院儿童使用肠道微生态制剂的相关特征，评估肠道微生态制剂的临床应用效果。方法以上海市儿童医院2012年度因肺炎住院儿童的用药医嘱记录为研究对象，描述性统计药物人群暴露量以及抗菌药物、肠道微生态制剂使用率与治疗开始时间，比较肠道微生态制剂治疗前后使用的抗菌药物品种数量、肠道微生态制剂合用及未合用的住院时间、止泻药治疗比例与时间等。结果2974人次用药医嘱纳入分析，接受抗感染药物治疗者2948人次（99．1％）、肠道微生态制剂治疗者1252人次（42．1％）、合并抗菌药物以及肠道微生态制剂治疗者1246人次（41．9％）。肠道微生态制剂起始治疗时间中位数为住院的第2天、众数为第1天。合并抗感染及菌群调节治疗者中，使用肠道微生态制剂前抗菌治疗时间中位数为3d，众数为1 d。肠道微生态制剂使用后抗菌治疗中位数为5 d，众数为4 d；肠道微生态制剂菌群调节治疗时间的中位数、众数均为4 d。肺炎住院儿童中使用止泻药者626人次（21．0％），主要集中在新生儿组和婴儿组。抗菌治疗合用肠道微生态制剂、未合用肠道微生态制剂的儿童分别有585人次（47．0％）、34人次（2．0％）接受止泻治疗，有显著性差异（P＜0.05）。合用肠道微生态制剂接受止泻治疗时间中位数为4 d，众数为3 d，四分位数Q1、Q3分别为2 d、6 d；未合用肠道微生态制剂接受止泻治疗时间中位数为3 d，众数为1 d，四分位数Q1、Q3分别为1 d、6 d，两组接受止泻治疗的时间没有显著性差异。抗菌治疗合用肠道微生态制剂的住院时间的中位数为7 d，众数为6 d，四分位数Q1、Q3分别为6 d、9 d；未合用肠道微生态制剂的住院时间的中位数、众数均为7 d，四分位数Q1、Q3分别为6 d、9 d，两组住院时间没有显著性差异。结论因肺炎住院儿童首次使用肠道微生态制剂主要在入院第2天，以预防使用为主。合用肠道微生态制剂对后续抗菌治疗的时间、止泻治疗时间、总体住院时间没有影响。菌群调节治疗措施对肺炎儿童的治疗协同效果需要进一步研究。目的：描述因肺炎住院兒童使用腸道微生態製劑的相關特徵，評估腸道微生態製劑的臨床應用效果。方法以上海市兒童醫院2012年度因肺炎住院兒童的用藥醫囑記錄為研究對象，描述性統計藥物人群暴露量以及抗菌藥物、腸道微生態製劑使用率與治療開始時間，比較腸道微生態製劑治療前後使用的抗菌藥物品種數量、腸道微生態製劑閤用及未閤用的住院時間、止瀉藥治療比例與時間等。結果2974人次用藥醫囑納入分析，接受抗感染藥物治療者2948人次（99．1％）、腸道微生態製劑治療者1252人次（42．1％）、閤併抗菌藥物以及腸道微生態製劑治療者1246人次（41．9％）。腸道微生態製劑起始治療時間中位數為住院的第2天、衆數為第1天。閤併抗感染及菌群調節治療者中，使用腸道微生態製劑前抗菌治療時間中位數為3d，衆數為1 d。腸道微生態製劑使用後抗菌治療中位數為5 d，衆數為4 d；腸道微生態製劑菌群調節治療時間的中位數、衆數均為4 d。肺炎住院兒童中使用止瀉藥者626人次（21．0％），主要集中在新生兒組和嬰兒組。抗菌治療閤用腸道微生態製劑、未閤用腸道微生態製劑的兒童分彆有585人次（47．0％）、34人次（2．0％）接受止瀉治療，有顯著性差異（P＜0.05）。閤用腸道微生態製劑接受止瀉治療時間中位數為4 d，衆數為3 d，四分位數Q1、Q3分彆為2 d、6 d；未閤用腸道微生態製劑接受止瀉治療時間中位數為3 d，衆數為1 d，四分位數Q1、Q3分彆為1 d、6 d，兩組接受止瀉治療的時間沒有顯著性差異。抗菌治療閤用腸道微生態製劑的住院時間的中位數為7 d，衆數為6 d，四分位數Q1、Q3分彆為6 d、9 d；未閤用腸道微生態製劑的住院時間的中位數、衆數均為7 d，四分位數Q1、Q3分彆為6 d、9 d，兩組住院時間沒有顯著性差異。結論因肺炎住院兒童首次使用腸道微生態製劑主要在入院第2天，以預防使用為主。閤用腸道微生態製劑對後續抗菌治療的時間、止瀉治療時間、總體住院時間沒有影響。菌群調節治療措施對肺炎兒童的治療協同效果需要進一步研究。
목적：묘술인폐염주원인동사용장도미생태제제적상관특정，평고장도미생태제제적림상응용효과。방법이상해시인동의원2012년도인폐염주원인동적용약의촉기록위연구대상，묘술성통계약물인군폭로량이급항균약물、장도미생태제제사용솔여치료개시시간，비교장도미생태제제치료전후사용적항균약물품충수량、장도미생태제제합용급미합용적주원시간、지사약치료비례여시간등。결과2974인차용약의촉납입분석，접수항감염약물치료자2948인차（99．1％）、장도미생태제제치료자1252인차（42．1％）、합병항균약물이급장도미생태제제치료자1246인차（41．9％）。장도미생태제제기시치료시간중위수위주원적제2천、음수위제1천。합병항감염급균군조절치료자중，사용장도미생태제제전항균치료시간중위수위3d，음수위1 d。장도미생태제제사용후항균치료중위수위5 d，음수위4 d；장도미생태제제균군조절치료시간적중위수、음수균위4 d。폐염주원인동중사용지사약자626인차（21．0％），주요집중재신생인조화영인조。항균치료합용장도미생태제제、미합용장도미생태제제적인동분별유585인차（47．0％）、34인차（2．0％）접수지사치료，유현저성차이（P＜0.05）。합용장도미생태제제접수지사치료시간중위수위4 d，음수위3 d，사분위수Q1、Q3분별위2 d、6 d；미합용장도미생태제제접수지사치료시간중위수위3 d，음수위1 d，사분위수Q1、Q3분별위1 d、6 d，량조접수지사치료적시간몰유현저성차이。항균치료합용장도미생태제제적주원시간적중위수위7 d，음수위6 d，사분위수Q1、Q3분별위6 d、9 d；미합용장도미생태제제적주원시간적중위수、음수균위7 d，사분위수Q1、Q3분별위6 d、9 d，량조주원시간몰유현저성차이。결론인폐염주원인동수차사용장도미생태제제주요재입원제2천，이예방사용위주。합용장도미생태제제대후속항균치료적시간、지사치료시간、총체주원시간몰유영향。균군조절치료조시대폐염인동적치료협동효과수요진일보연구。
Objective To describe the profile of probiotics utilization in hospitalized pneumonia children and evaluate the ef -fectiveness of probiotics in the treatment of pneumonia in hospitalized children combined with antibiotics. Methods Descriptive data a-nalysis was obtained from the medical records in one children′s hospital in one year period. The clinical data including patient charac-teristics, drug prescribed time, drug use duration, and length of stay was reviewed. Ridit analysis was used to compare the data. Re-sults Data of 2 974 children hospitalized for pneumonia was accessed. Antibiotics were prescribed to 99.1 % ( n=2 948) of pa-tients, probiotics were prescribed to 42.1%(n=1 252) of patients, and both antibiotics and probiotics were prescribed to 41.9%(n=1 246 ). The median of the time to start administration of probiotics was the second day of hospitalization and the mode was the first day of hospitalization. For those patients who were prescribed antibiotics combined with probiotics, the median of the duration of ad-ministration of antibiotics before accepting probiotics was 3 days and the mode was 1 day.After administrating probiotics, the median of the duration of accepting of antibiotics was 5 days, the mode was 4 days, and the median and the mode of the duration of administration of probiotics were 4 days.21%(n=626) of all hospitalized patients were administrated anti-diarrheals.The most common age group of them were neonates and infants (82.3%, n=515).The patients with anti-diarrheal who was administrated antibiotics with or with-out probiotics were 585(47.0%), 34(2.0%), respectively (P<0.05).The median of duration of anti-diarrheals in those adminis-trated antibiotics with probiotics was 4 days, the mode was 3 days and the interquartile range was 2-6 days.For those administrated an-tibiotics without probiotics, the median of duration of anti-diarrheals was 3 days, the mode was 1 day and the interquartile range was 1-6 days (P>0.05).The median of the length of stay in those administrated antibiotics with probiotics was 7 days, the mode was 6 days and the interquartile range was 6-9 days.For those administrated antibiotics without probiotics, the median and the mode of the length of stay were 7 days and the interquartile range was 6-9 days(P>0.05).Conclusion The time of starting to administrate probiotics was mainly within 2 days combined with antibiotics. The aim of prescribed probiotics was prevention of antibiotic-associated diarrhea. There was no significant difference in the duration of the following antibiotic therapy, the duration of anti-diarrhea therapy, the length of stay between those administrated antibiotics combination with or without probiotics.