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阿洛西林在儿童铜绿假单胞菌性中耳炎治疗中的作用

[Role of azlocillin in the treatment of Pseudomonas aeruginosa otitis in children].

作者信息

Damay M, Ployet M J, Borderon J C

出版信息

Presse Med. 1984 Mar 29;13(13):812-4.

PMID:6231601
Abstract

From May, 1978 to October, 1983, 88 children with otitis due to Pseudomonas aeruginosa were seen at Paediatric Unit E.N.T. consultation of the University Hospital of Tours. Epidemiologically, it is worth mentioning that the majority of these infections was not of nosocomial origin: 56 children were infected outside the hospital and 26 during their stay in hospital; 3 neonates were referred directly from the Maternity Unit. Most strains of Ps. aeruginosa, with various serotypes, were sensitive to azlocillin. Twenty-four children received a systemic treatment required by their local or general condition. Azlocillin was used in 24 cases on the basis of positive sensitivity tests and was occasionally combined with topical treatment using antiseptics or the antibiotic itself. Or the 3 failures observed, 2 were due to acquired resistance to azlocillin and 1 to chronic otitis. An incomplete result was obtained in a case of otitis externa caused by a strain of intermediate sensitivity. The remaining 19 cases were cured, including 3 neonates with otitis externa or media, 1 child with otitis externa, 1 with combined otitis externa and media, 10 with otitis media, usually protracted, 2 with mastoiditis medically cured and 1 with superinfection following mastoidectomy for cholesteatoma. Secretions dried up within 3 to 4 days and treatment was discontinued after clinical cure was obtained in 9 to 19 days. Fever, which was present in 7 cases, abated within 2 to 8 days. The only relapse that occurred, one month after treatment of an otitis media, responded to a second course of azlocillin.

摘要

1978年5月至1983年10月期间,图尔大学医院儿科耳鼻喉科会诊时共接诊了88例由铜绿假单胞菌引起中耳炎的儿童患者。从流行病学角度来看,值得一提的是,这些感染大多数并非医院内感染:56名儿童在院外感染,26名在住院期间感染;3名新生儿直接从产科转入。大多数不同血清型的铜绿假单胞菌菌株对阿洛西林敏感。24名儿童因局部或全身状况需要接受全身治疗。基于药敏试验阳性结果,24例使用了阿洛西林,偶尔还联合使用防腐剂或抗生素本身进行局部治疗。在观察到的3例治疗失败病例中,2例是由于对阿洛西林产生了获得性耐药,1例是由于慢性中耳炎。1例由中度敏感菌株引起的外耳道炎病例治疗结果不完全。其余19例治愈,包括3例患有外耳道炎或中耳炎的新生儿、1例患有外耳道炎的儿童、1例患有外耳道炎合并中耳炎的儿童、10例通常为迁延性的中耳炎患儿、2例经药物治愈的乳突炎患儿以及1例因胆脂瘤行乳突切除术后发生二重感染的患儿。分泌物在3至4天内干涸,在9至19天临床治愈后停止治疗。7例出现发热症状的患儿,发热在2至8天内消退。唯一的1例复发发生在1例中耳炎治疗后1个月,再次使用阿洛西林治疗有效。

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