在患有状细胞疾病的患者中进行青素预防,年龄超过5岁
Tyler G Eastep1, Rebecca M Kendsersky1, Jessica Zook1
1Department of Pharmacy (TGE, RMK, JZ, AM), Children's Hospital of Philadelphia, Philadelphia, PA.
在5岁以后,停止在患有状细胞病 (SCD) 的儿童中使用青素预防是安全有效的. 在停止预防的患者中,没有侵入性肺炎球菌病 (IPD) 发生,这支持大多数SCD患者停止处方.
科学领域:
- 儿科血液学 儿科血液学
- 传染性疾病 传染性疾病
- 药理学 药理学 是一个学科.
背景情况:
- 患有状细胞病 (SCD) 的患者面临侵入性肺炎球菌病 (IPD) 的风险增加.
- 虽然指导方针建议在5岁时停止抗微生物预防,但它通常会无限期地继续.
- 这种做法引起了人们对抗生素耐药性和潜在的不良影响的担忧.
研究的目的:
- 评估在接受青素预防治疗的SCD儿科患者中培养阳性IPD和其他感染的发生率,与停止接受青素预防治疗的患者相比.
- 在这个人群中评估停止处方抗微生物预防的安全性和有效性.
主要方法:
- 一个单一中心的回顾性队列研究比较了继续接受青素预防的儿科SCD患者与停止接受青素预防的患者.
- 包括5-18岁没有先前IPD或脊髓切除术的患者.
- 对人口统计,免疫,青素使用和感染史的数据进行了审查.
主要成果:
- 65%的患者在5岁以后继续抗菌预防,特别是那些患有严重SCD类型的患者.
- 没有停止预防治疗的患者患有IPD.
- 一名接受持续预防的患者死于肺炎败血症;其他感染率在各组之间相似.
结论:
- 停止处方青素预防适用于大多数小儿SCD患者,而不是IPD的高风险.
- 需要对替代药物进行进一步的研究,提供者继续治疗的理由,以及对生活质量的影响.
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