CAJ | 학술논문

目的:探讨慢性阻塞性肺疾病(COPD)加重期初始经验性抗生素的治疗策略.方法:将207例COPD加重期患者按照初始经验性抗生素治疗用药分为两组:A组(145例)初始经验性抗生素治疗覆盖非典型病原体,B组(62例)初始经验性抗生素治疗不覆盖非典型病原体.结果:207例患者痰培养阳性55例,阳性率26.6%.以革兰阴性菌为主;症状体征缓解时间覆盖非典型病原体组与不覆盖非典型病原体组差异有显著性(P<0.05),而体温降至正常的时间、住院天数及治疗失败例数方面差异均无显著性(P>0.05).结论:COPD加重期并感染患者初始用药目前可不覆盖非典型病原体,但若临床抗生素疗效不佳者,应警惕非典型病原体感染的可能,及时加用大环内酯类抗生素或氟喹诺酮类抗生素.
목적:탐토만성조새성폐질병(COPD)가중기초시경험성항생소적치료책략.방법:장207례COPD가중기환자안조초시경험성항생소치료용약분위량조:A조(145례)초시경험성항생소치료복개비전형병원체,B조(62례)초시경험성항생소치료불복개비전형병원체.결과:207례환자담배양양성55례,양성솔26.6%.이혁란음성균위주;증상체정완해시간복개비전형병원체조여불복개비전형병원체조차이유현저성(P<0.05),이체온강지정상적시간、주원천수급치료실패례수방면차이균무현저성(P>0.05).결론:COPD가중기병감염환자초시용약목전가불복개비전형병원체,단약림상항생소료효불가자,응경척비전형병원체감염적가능,급시가용대배내지류항생소혹불규낙동류항생소.
Objective:To discuss the initial empirical antibiotics treatment strategy for exacerbated chronic obstructive pulmonary disease (COPD). Methods:207 cases of exacerbated COPD were divided into two groups according to the initial empirical antibiotics treatment drugs. The treatment drug in Group A including 145 patients covered atypical pathogens while the treatment drug in Group B including 62 patients did not cover atypical pathogens. Results:The sputum cultivation of 55 cases were positive, accounting for 26.6% of 207 patients and in which the main pathogen was gram-negative bacteria. The symptom relief time between grouop A and B was statisti-cally different (P<0.05) while the body temperature normality time, days in hospital and treatment failed cases between grouop A and B was not statistically different (P>0.05). Conclusion:The initial empirical antibiotics treatment strategy for exacerbated COPD may not cover atypical pathogens.However,if the clinical antibiotics treatment effect is not good,the atypical pathogen infection should be consid-ered and the cyclical lactone and fluoroquinolone drugs should be added.