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頁籤選單縮合
題名 | Antibiotic therapy for newborn infants with suspected infection=新生兒疑似感染病例之抗生素療法 |
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作者姓名(中文) | 廖美芬; 曹龍彥; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 29:4 民77.07-08 |
頁次 | 頁221-228 |
分類號 | 417.517 |
關鍵詞 | 抗生素; 病例; 感染; 新生兒; 疑似; 療法; |
語文 | 英文(English) |
中文摘要 | 新生兒感染乃是造成新生兒死亡的重要原因之一。近幾年來,隨著許多新一代廣效性抗生素的被發現,臨床醫師們期望對於新生兒感染症能施以有效的治療。但是,新生兒感染在病症的早期症狀往往不太明顯,且常缺乏特異之徵兆;再加上許多現行的實驗室診斷方法在疾病之初期未能有效地確立診斷。就因為如此,對於臨床上懷疑感染的新生兒,臨床醫師在本著早期治療的原則上,常施予大量且長時間的抗生素治療,常常使得這些新生兒接受了不須要的抗生素。這不但造成了家屬金錢上的浪費,而且對於新生兒往往造成許多不良的後遺症,此實為不容忽視的事實。所以,在這個前提下,本院嬰兒室自民國七十三年九月份起,對於在本院出生接而住進本院嬰兒室的新生兒,我們嚴格地建立了使用抗生素的治療原則。在周產期間,凡有母親早期破水,母體發燒,羊膜發炎或者嬰兒有不明原因的呼吸窘迫,體溫不穩,發熱,低體溫,持續性之黃疸,皆是我們在嬰兒室中使用抗生素的對象。所有使用抗生素治療的嬰兒在用藥之前皆施以血中白血球之分類以及周邊靜脈血,尿液之細菌培養。至於三天後,所有之細菌培養皆呈陰性反應,且臨床上嬰兒並無感染徵兆者,我們再施以血中白血球之分類檢查以及血清中CRP之定性試驗作為我們停用抗生素之指標。由此研究中顯示利用此使用及停用抗生素之原則,我們可以有效地控制嬰兒室的新生兒感染,而且可避免大量且長期的使用抗生素,避免不必要的浪費。 |
英文摘要 | Two hundred and ninty newborn infants suspected to have infection were the subjects of carefully evaluation during an one-year study period. They were put on empirical antibiotics treatment because of maternal infection and/or clinical symptoms suggesting infection. Sixty-one of the 290 infants were subsequently proved by bacteriologic cultures to have infection. Comparison between the culture-positive and culture-negative groups, showed no significant difference in sex, birth weight or gestational age. However the infected group were older and appeared to have more symptoms and signs of infection, especially diarrhea, jaundice and poor feeding. Bedides maternal fever, premature rupture pf membranes (PROM) and fetal distress could also have been high indicators for infection. Various screening tests; white blood cell count (WBC), Total neutrophil count (TNC), Immature neutrophil count (INC), Immature/total neutrophil (I/T) ratio and slide serum C-reactive protein (CRP) tests were used to evaluate the existence of infection. For this study, the INC and l1T ratio were the most reliable and quickly executed. A negative slide serum CRP test in infants with negative blood culture could be ultilized as an indicator for discontinuation of antibiotic therapy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。