Lanbeck Peter, Odenholt Inga, Paulsen Otto
Department of Infectious Diseases, Malmö University Hospital, Lund University, Malmö, Sweden.
Scand J Infect Dis. 2002;34(7):512-9. doi: 10.1080/00365540110080908.
Intravenous administration of antibiotics is a known risk factor for infusion phlebitis. We have previously demonstrated differences in cell toxicity for 4 antibiotics. Clinical experience indicates that antibiotics differ in their tendency to cause phlebitis. The present study was done prospectively on 550 patients with 1386 peripheral venous catheters. The incidence of phlebitis was 18.5% with antibiotics and 8.8% without (odds ratio 2.34). Dicloxacillin (odds ratio 5.74) and erythromycin (odds ratio 5.33) had the greatest tendency to cause phlebitis in univariate, multivariate and Cox regression analyses. Benzylpenicillin, cefuroxime and cloxacillin were also associated with a greater risk of phlebitis, whereas ampicillin, imipenem/cilastatin, clindamycin, netilmicin and vancomycin were not. Other risk factors were the site of insertion and age 51-60 y. Medication with warfarin was found to be protective, but not with aspirin. Treatment with low molecular weight heparin reduced the risk of phlebitis, but the difference was not significant. With regard to when antibiotics were given, the day-specific risk increased between Days 1 and 2, but no further on subsequent days. The hypothesis that antibiotics differ in their tendency to cause phlebitis was confirmed.
静脉注射抗生素是已知的输液性静脉炎风险因素。我们之前已证明4种抗生素在细胞毒性方面存在差异。临床经验表明，不同抗生素导致静脉炎的倾向有所不同。本研究对550例患者的1386根外周静脉导管进行了前瞻性研究。使用抗生素时静脉炎的发生率为18.5%，未使用时为8.8%（比值比为2.34）。在单因素、多因素及Cox回归分析中，双氯西林（比值比为5.74）和红霉素（比值比为5.33）导致静脉炎的倾向最大。苄青霉素、头孢呋辛和氯唑西林也与静脉炎风险增加相关，而氨苄西林、亚胺培南/西司他丁、克林霉素、奈替米星和万古霉素则不然。其他风险因素包括导管插入部位及年龄在51 - 60岁。发现使用华法林具有保护作用，但阿司匹林则不然。使用低分子量肝素治疗可降低静脉炎风险，但差异不显著。关于抗生素给药时间，第1天至第2天特定日风险增加，但后续日子未进一步增加。抗生素导致静脉炎的倾向存在差异这一假设得到了证实。
