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替卡西林/克拉维酸组合。住院儿童细菌感染的治疗。

Ticarcillin/clavulanic acid combination. Treatment of bacterial infections in hospitalized children.

作者信息

Kristjansson K, Cox F, Taylor L

机构信息

Department of Pediatrics, Medical College of Georgia, Augusta 30912.

出版信息

Clin Pediatr (Phila). 1989 Nov;28(11):521-4. doi: 10.1177/000992288902801106.

Abstract

Eighteen patients 2 months to 11 years of age with culture proven bacterial infections were treated with parenteral ticarcillin/clavulanic acid in a noncomparative study. Seven patients had pneumonia, two had tracheobronchitis, three had soft tissue abscess, two had periorbital cellulitis, three had urinary tract infection and one had purulent bursitis. Four of the 18 were bacteremic. Organisms treated included Staphylococcus aureus (6), Pseudomonas aeruginosa (5), Haemophilus influenzae (2), Branhamella catarrhalis (2), Escherichia coli (1), Streptococcus pneumoniae (1), Klebsiella pneumoniae (1), Streptococcus pyogenes (1) and Serratia marcescens (1). Thirteen of 15 (87%) organisms tested were beta-lactamase positive. Therapy was given intravenously in six doses per day at 310 mg/kg. Duration of treatment ranged from 5 to 28 (mean 11) days, with an average time of 4 days to clinical improvement. Seventeen patients (94%) were clinically cured. One patient with recurrent aspiration pneumonia due to mixed infection with multiple gram-negative enteric bacilli failed therapy. Adverse effects were minimal and transient. Notably, mild to moderate thrombocytosis occurred in four (22%) patients that resolved uneventfully. We conclude that ticarcillin/clavulanic acid is safe and effective therapy for serious infections in hospitalized children.

摘要

在一项非对照研究中,对18例年龄在2个月至11岁、经培养证实有细菌感染的患者采用静脉注射替卡西林/克拉维酸进行治疗。7例患有肺炎,2例患有气管支气管炎,3例患有软组织脓肿,2例患有眶周蜂窝织炎,3例患有尿路感染,1例患有脓性滑囊炎。18例中有4例发生菌血症。所治疗的病原体包括金黄色葡萄球菌(6例)、铜绿假单胞菌(5例)、流感嗜血杆菌(2例)、卡他布兰汉菌(2例)、大肠杆菌(1例)、肺炎链球菌(1例)、肺炎克雷伯菌(1例)、化脓性链球菌(1例)和粘质沙雷菌(1例)。15例检测的病原体中有13例(87%)β-内酰胺酶阳性。治疗采用静脉注射,每日6次,剂量为310mg/kg。治疗时间为5至28天(平均11天),平均4天出现临床改善。17例患者(94%)临床治愈。1例因多种革兰氏阴性肠道杆菌混合感染导致复发性吸入性肺炎的患者治疗失败。不良反应轻微且短暂。值得注意的是,4例(22%)患者出现轻度至中度血小板增多症,均顺利缓解。我们得出结论,替卡西林/克拉维酸对住院儿童的严重感染是一种安全有效的治疗方法。

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