接受抗真菌药物治疗的重症监护病房患者中与抗生素相关性腹泻相关的因素：一项单中心回顾性研究。

Factors related to antibiotic-associated diarrhea in patients in the intensive care unit receiving antifungals: a single-center retrospective study.

作者信息

Jingjing Sun, Yanshu Zhang, Yu Liu, Qindong Shi, Xue Wang, Lei Zhang, Yingli He, Litao Guo

机构信息

1 Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

2 Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

J Int Med Res. 2019 May;47(5):2067-2076. doi: 10.1177/0300060519836305. Epub 2019 Mar 21.

DOI:10.1177/0300060519836305

PMID:30898003

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6567793/

Abstract

OBJECTIVE

To analyze factors related to antibiotic-associated diarrhea (AAD) in patients in the intensive care unit (ICU) receiving antifungals with the aim of informing rational antibiotic use.

METHODS

Sex, age, medical history, use of proton pump inhibitors, administration of parenteral nutrition, albumin level, occurrence of AAD, type of antibiotics, duration of ICU admission, and prognosis were retrospectively analyzed. The associations of age, sex, medical history, and other factors with AAD were associated by logistic regression.

RESULTS

In total, 284 patients were enrolled (antifungals, n = 110; no antifungals, n = 174). The total incidence of AAD was 32.39%. The incidence of AAD was significantly different between the groups (52.73% vs. 19.54%). The duration of proton pump inhibitor therapy, duration of antifungal therapy, enzyme inhibitor antibiotic use, and azithromycin use were associated with AAD in ICU patients receiving antifungal therapy. The mean duration of ICU admission was higher in patients receiving antifungal therapy (20.14 ± 11.50 vs. 14.48 ± 8.54 days). There was no significant difference in ICU mortality rates.

CONCLUSION

The duration of proton pump inhibitor therapy, duration of antifungal therapy, use of enzyme inhibitor antibiotics, and use of azithromycins were associated with AAD in ICU patients receiving antifungal therapy.

摘要

目的

分析重症监护病房（ICU）接受抗真菌药物治疗的患者中与抗生素相关性腹泻（AAD）相关的因素，以指导合理使用抗生素。

方法

回顾性分析患者的性别、年龄、病史、质子泵抑制剂的使用情况、肠外营养的给予情况、白蛋白水平、AAD的发生情况、抗生素类型、ICU住院时间及预后。通过逻辑回归分析年龄、性别、病史及其他因素与AAD的相关性。

结果

共纳入284例患者（抗真菌药物组，n = 110；未使用抗真菌药物组，n = 174）。AAD的总发生率为32.39%。两组间AAD的发生率有显著差异（52.73%对19.54%）。在接受抗真菌治疗的ICU患者中，质子泵抑制剂治疗时间、抗真菌治疗时间、酶抑制剂抗生素的使用及阿奇霉素的使用与AAD相关。接受抗真菌治疗的患者ICU平均住院时间更长（20.14±11.50天对14.48±8.54天）。ICU死亡率无显著差异。