在儿童中怀疑单纯疹病毒感染的亲肠道阿西克洛维尔:0-18岁
Angela Berkhout1,2,3,4,5, Julia E Clark1,2, Cheryl A Jones3,6,7
1Infection Management and Prevention Service, The Queensland Children's Hospital, Brisbane, Queensland 4101, Australia.
The Journal of antimicrobial chemotherapy
|November 18, 2024
概括
静脉注射的阿西克洛维尔 (一种简单疹病毒药物) 经常被处方给儿童,通常是不必要的. 不完整的简单疹病毒 (HSV) 检测导致接受这种治疗的老年儿童的许多未经证实的诊断.
科学领域:
- 儿童传染病 儿童传染病
- 抗病毒疗法 抗病毒疗法
- 临床药理学 临床药理学
背景情况:
- 在怀疑单纯疹病毒 (HSV) 疾病时,新生儿处方静脉注射阿西克洛维尔显示出了变化.
- 对于老年儿科患者的阿西克洛维尔处方模式存在有限的数据.
研究的目的:
- 对新生儿和儿童怀疑HSV疾病的静脉注射阿西克洛维尔处方实践进行分析.
- 根据HSV测试和确定的诊断来评估阿西克洛维尔使用的适当性.
主要方法:
- 对接受静脉注射阿西克洛维尔的新生儿和儿童 (18岁以下) 的医疗记录的回顾性审查.
- 收集的数据包括指示,HSV测试,处方细节,不良事件和出院诊断.
- 这项研究是在2019年1月至2019年12月期间在澳大利亚和新西兰的八家医院进行的.
主要成果:
- 1426名患者接受了经验性静脉注射的阿西克洛维尔.
- 在新生儿中 (n=425),HSV疾病在13/425确诊.
- 在年龄较大的儿童中 (n=1001),只有5/770人怀疑传播HSV疾病或脑炎的确诊; 69/136人怀疑粘膜皮肤疾病的确诊HSV.
- 报告了毒性和扩散性损伤的不良事件.
结论:
- 静脉注射的阿西克洛维尔经常被处方给儿童怀疑HSV脑炎或传播疾病,往往没有适当的HSV调查.
- 显著比例的老年儿童因未经证实的HSV诊断而接受了不必要的阿西克洛维尔治疗.
- 诸如毒性和扩散性损伤等不良事件突显了与经验性阿西克洛维尔使用相关的潜在风险.
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