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根据住院儿童腰椎穿刺脑脊液结果的抗生素治疗干预频率分布

Frequency Distribution of Antibiotic Therapy Intervention According to Lumbar Puncture Cerebrospinal Fluid Outcome in Hospitalized Children.

作者信息

Ferdosian Farzad, Kheyrabadi Alireza Eghbali, Nafei Zahra

机构信息

Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Maedica (Bucur). 2020 Dec;15(4):454-460. doi: 10.26574/maedica.2020.15.4.454.

Abstract

The aim of this study was to evaluate the frequency distribution of antibiotic therapy according to lumbar puncture outcome in hospitalized children. This study was conducted on 94 children undergoing lumbar puncture. All data were extracted from medical records. Administration of primary treatments and initial diagnosis including febrile convulsion, meningitis, and encephalitis in these patients were based on a physician's opinion. The majority of subjects were diagnosed with febrile convulsion. Antibiotic treatment before lumbar puncture was taken by 58 children. After lumbar puncture, 35 children discontinued antibiotic therapy, two patients were switched to another antibiotic treatment and 21 subjects continued antibiotic medication. In addition, 36 children did not take antibiotics. Positive PCR was found in four cases from the encephalitis group. After lumbar puncture, antibiotic treatment was continued in 23 cases, whereas administration of antibiotics could be justified only in four cases based on positive PCR. Given that antibiotic treatment of our subjects was initiated prior to lumbar puncture but it was changed in two cases and continued in 21 cases after the medical procedure, conducting lumbar puncture seemed to be not very useful in these patients, assuming that laboratory signs or symptoms could justify an antibiotic treatment.

摘要

本研究的目的是根据住院儿童腰椎穿刺结果评估抗生素治疗的频率分布。本研究对94例接受腰椎穿刺的儿童进行。所有数据均从病历中提取。这些患者的主要治疗和初始诊断(包括热性惊厥、脑膜炎和脑炎)基于医生的意见。大多数受试者被诊断为热性惊厥。58名儿童在腰椎穿刺前接受了抗生素治疗。腰椎穿刺后,35名儿童停止抗生素治疗,2名患者改用另一种抗生素治疗,21名受试者继续使用抗生素药物。此外,36名儿童未使用抗生素。脑炎组有4例PCR检测呈阳性。腰椎穿刺后,23例继续使用抗生素治疗,但基于PCR阳性结果,仅4例使用抗生素治疗合理。鉴于我们的受试者在腰椎穿刺前就开始了抗生素治疗,但在两例中治疗方案发生了改变,21例在医疗程序后继续治疗,假设实验室检查结果或症状能够证明抗生素治疗合理,那么腰椎穿刺在这些患者中似乎用处不大。

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