Li Han-wei, Zhao Ping, Wang Hui-fen, Ji Wei, He Wei-ping, Du Ning, Xia Jie
The Sixth Department of No. 302 Hospital of PLA, Beijing 100039, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2004 Jun;18(2):179-80.
To observe the effects of short-term antibiotic treatment in patients with hepatic failure and spontaneous bacterial peritonitis (SBP).
In this prospective study short-term antibiotic treatment was given to 67 cases diagnosed as hepatic failure with spontaneous bacterial peritonitis. Ceftriaxone 2 g, iv drip, q12h for 10 d or ofloxacin 0.2 g, iv drip, q12h for 10 d was given to the patients at random and the efficacy was evaluated on the basis of clinical symptoms, medical examination and ascites after 3, 7, 10 days of therapy.
Seven cases (10.44%) were cured and 57 cases (85%) were improved after 3 days therapy, the total effective rate was 95.52%, but in 3 cases the therapy had no effect. The results of ascites bacterial culture and drug susceptibility test showed that one case had drug resistance to ceftriaxone and two cases had drug resistance to ofloxacin, so antibiotics were changed in time. After 7 days therapy, the results showed that 65 cases (97.01%) cured and 2 cases (2.99%) were improved, the total effective rate was 100%. When the therapy lasted for 10 days, all patients were cured. One patient had oral mucous membrane. Candida albicans infection after 3 days therapy; two cases got thrush and one patient got fungal intestinal infection after 7 days therapy; when the therapy lasted for 10 days, 4 cases had thrush and 2 cases had fungal infection of intestines and one patient had pulmonary fungal infection.
The optimal period of antibiotic treatment of hepatic failure with SBP should be from 7 days to 10 days.
观察短期抗生素治疗对肝衰竭合并自发性细菌性腹膜炎(SBP)患者的疗效。
在这项前瞻性研究中,对67例诊断为肝衰竭合并自发性细菌性腹膜炎的患者进行短期抗生素治疗。随机给予患者头孢曲松2g,静脉滴注,每12小时1次,共10天;或氧氟沙星0.2g,静脉滴注,每12小时1次,共10天,并根据治疗3、7、10天后的临床症状、体格检查和腹水情况评估疗效。
治疗3天后,7例(10.44%)治愈,57例(85%)好转,总有效率为95.52%,但有3例治疗无效。腹水细菌培养及药敏试验结果显示,1例对头孢曲松耐药,2例对氧氟沙星耐药,及时更换了抗生素。治疗7天后,结果显示65例(97.01%)治愈,2例(2.99%)好转,总有效率为100%。治疗10天时,所有患者均治愈。1例患者在治疗3天后出现口腔黏膜白色念珠菌感染;7天后2例出现鹅口疮,1例出现真菌性肠道感染;治疗10天时,4例出现鹅口疮,2例出现肠道真菌感染,1例出现肺部真菌感染。
肝衰竭合并SBP患者抗生素治疗的最佳疗程应为7天至10天。