术后哌拉西林-他唑巴坦单药治疗与头孢噻肟和甲硝唑联合多药治疗儿童穿孔阑尾炎:病例对照研究

S. Chun, D. Kim, S. Kim, J. Namgoong
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摘要

目的:最近的数据表明,使用广谱抗生素的单药治疗可能与标准的多药治疗一样有效,而且可能比多药治疗更便宜。我们比较了静脉注射哌拉西林-他唑巴坦(PT)单药治疗与头孢噻肟、甲硝唑(CM)多药治疗的术后并发症和住院时间。方法:回顾性分析2013年4月至2014年5月收治的小儿穿孔性阑尾炎患者的住院记录和医疗费用。结果:我们的研究包括46例腹腔镜阑尾切除术治疗穿孔性阑尾炎。PT组20例,CM组26例。入院时,性别分布、症状持续时间、白细胞计数和CRP水平无显著性差异。术后第3、5、7天,PT组与CM组白细胞计数、中性粒细胞百分比、CRP差异无统计学意义。两组患者的脓肿形成率、伤口感染、住院时间均无差异。CM组仅1例因CRP及白细胞计数升高再次入院。结论:每日给药单药治疗与多药治疗CM疗效相当。为了评估广谱抗生素单药治疗儿童穿孔阑尾炎的疗效,需要纳入更多的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postoperative Monotherapy with Piperacillin-Tazobactam versus Multidrug Therapy with Cefotaxime and Metronidazole for Perforated Appendicitis in Children: A Case-Control Study
Purpose: Recent data suggest that monotherapy with a broad-spectrum antibiotic may be as efficacious as, and potentially less costly than, standard multi-drug therapy. We compared mono-therapy with intravenous piperacillin-tazobactam (PT) with multi-drug therapy with cefotaxime and metronidazole (CM) in aspect of postoperative complications and hospital stay. Methods: We reviewed the hospital records and medical costs of the pediatric patients who were managed for perforated appendicitis between April 2013 and May 2014 retrospectively. Results: Forty-six patients with laparoscopic appendectomy for perforated appendicitis were included in our study. PT group was 20 and CM group was 26 patients. On admission, there were no significance in sex distribution, duration of symptoms, leukocyte count, and CRP levels. At postoperative third, fifth, and seventh day of each regimen, PT group have no statistical difference with CM group in leukocyte count, percentage of neutrophil, and CRP. There was no difference in abscess formation rate, wound infections, and hospital stay between two groups. There was only one patient who was readmitted with elevation of CRP and leukocyte count in CM group. Conclusion: Daily dosing with the mono-therapy of PT offers as efficient as multi-drug therapy of CM. To evaluate the efficacy of broad-spectrum antibiotics monotherapy in perforated appendicitis children, the cohort included more patients should be needed.
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