评估儿童中链球菌毒性休克综合征的抗生素治疗方案
Haixia Zhang1, Jie Dong2, Jiaotian Huang3
1Department of Pharmacy, Hunan Children's Hospital, Changsha, China.
PloS one
|October 12, 2023
概括
儿科链球菌毒性休克综合征 (STSS) 治疗最有效的是基于青素的疗法. 使用β-乳糖抗生素,克林达米辛和IVIG的早期干预可以改善这种严重的Streptococcus pyogenes感染儿童的结果.
科学领域:
- 传染性疾病 传染性疾病
- 儿科重症监护中心儿童重症监护中心
- 微生物学 微生物学
背景情况:
- estreptococcal毒性休克综合征 (STSS) 是一种严重的,危及生命的疾病,由儿童感染Streptococcus pyogenes引起.
- 儿童STSS的有效管理取决于早期诊断和及时给予适当的抗感染疗法.
- 关于不同抗微生物治疗方案对儿科STSS的比较有效性的数据有限.
研究的目的:
- 评估各种抗微生物治疗策略对儿科 estreptococcal 毒性休克综合征的疗效.
- 确定最佳的抗生素选择和辅助疗法,以改善STSS儿童的治疗结果.
主要方法:
- 从两个医院的32例儿科STSS病例的临床数据的回顾性分析 (2009年1月 - 2023年4月).
- 来自中国国家知识基础设施的儿科STSS病例的系统文献综述.
- 根据成分对抗微生物治疗的分类,再加上对辅助疗法的分析,将其分为四组.
主要成果:
- 所有分析的STSS病例都显示细菌对安培素,β-乳糖抗生素和万科米辛有敏感性,但对克林达米辛,红素和四环素有耐药性.
- 总共有82名患者 (32名来自研究,50名来自文献) 被评估.
- 含有青素的疗法显示出最高的疗效率 (86.4%),而类/未使用的抗生素组的疗效为0%. 其他治疗方案的疗效率分别为32.1%和42.3%.
结论:
- 在儿科STSS病例中,Streptococcus pyogenes对安比西林表现出显著的敏感性.
- 及时服用β-乳酸抗生素,特别是青素,结合克林达米辛和静脉注射免疫球蛋白 (IVIG),与治疗成功的提高有关.
- 这些发现支持使用基于青素的疗法作为儿科STSS的主要治疗策略.
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