摘要
目的分析阿莫西林-双氯西林联合治疗蜂窝组织炎伴高热患者的临床疗效,为蜂窝组织炎患者临床治疗方案选择提供参考。方法对医院收治的22例蜂窝组织炎伴高热患者采用阿莫西林-双氯西林联合治疗,同时对患者病变部位取样进行病原学分析,分析患者阿莫西林-双氯西林联合治疗前后临床症状改善情况、炎症细胞因子(IL-6、IL-8、IL-10、超敏C-反应蛋白)的改善情况,根据患者临床治疗的疗效及病原学-药敏分析结果调整敏感抗菌药物治疗,统计患者调整抗菌药物治疗情况,分析阿莫西林-双氯西林联合治疗蜂窝组织炎伴高热患者的临床价值。结果 22例患者临床症状为典型的蜂窝组织炎症状;22例患者患部擦拭取样或脓液进行病原菌培养,共分离出25株病原菌,其中革兰阳性菌17株(均为金黄色葡萄球菌),革兰阴性菌6株(溶血性链球菌5株,硝化菌1株),真菌2株;22例患者经阿莫西林-双氯西林联合治疗后,20例患者的临床症状明显改善,2例患者改用敏感抗菌药物后临床症状改善;患者治疗后炎症细胞因子(IL-6、IL-8、IL-10、超敏C-反应蛋白)均较治疗前明显降低(P<0.05),IL-10较治疗前明显升高(P<0.05),2例患者治疗3d后临床症状无明显改善,调整敏感抗菌药物治疗后,获得较好疗效。结论蜂窝组织炎伴高热患者临床较为少见,阿莫西林联合双氯西林对其进行经验性治疗,可有效涵盖病原菌谱,疗效较好,使患者得到及时治疗,具有较高的临床价值。
OBJECTIVE To observe the clinical effect of amoxicillin combined with dicloxacillin on treatment of cellulitis patients complicated with high fever so as to provide guidance for clinical treatment of the patients with cellutis.METHODS A total of 22 cellulitis patients complicated with high fever who were treated with amoxicillin combined with dicloxacillin were enrolled in the study,the lesion sites were sampled for etiological analysis,the clinical symptoms and levels of inflammatory cytokines（IL-6,IL-8,IL-10,high-sensitivity C-reactive protein）were observed before and after the patients were treated with amoxicillin combined with dicloxacillin,the use of sensitive antibiotics was adjusted based on the clinical therapeutic effect and the result of etiology-drug susceptibility analysis,the adjustment of the antibiotics therapy was statistically analyzed,and the clinical value of amoxicillin combined with dicloxacillin in treatment of the cellulitis patients complicated with high fever was analyzed.RESULTS The cellulitis was the typical clinical symptom of the 22 patients.The lesion sites or pus specimens were sampled from the 22 patients for culture of pathogens,totally 25 strains of pathogens were isolated,including 17 strains of gram-positive bacteria（all were Staphylococcus aureus）,6strains of gram-negative bacteria（5strains of Streptococcus hemolyticus,1strain of nitrobacterium）,and 2strains of fungi.The clinical symptoms of 20 in 22patients were remarkably improved after the treatment with amoxicillin combined with dicloxacillin,the clinical symptoms of 2patients were improved after they were transferred to be treated with sensitive antibiotics.The levels of inflammatory cytokines（IL-6,IL-8,IL-10,and high-sensitivity C-reactive protein）of the patients were significantly lower after the treatment than before the treatment（P〈0.05）,the IL-10 level was significantly elevated after the treatment（P〈0.05）.The clinical symptoms of 2patients were not improved remarkably after the treatment for 3 days,but good therapeutic effect was achieved after the adjustment of sensitive antibiotics.CONCLUSIONIt is rare in hospital that the cellulitis is complicated with high fever,the empirical treatment with amoxicillin combined with dicloxacillin can effectively cover the spectrum of pathogenic bacteria,achieve good therapeutic effect,and make the patients receive timely treatment;it has high clinical value.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第9期2092-2095,共4页
Chinese Journal of Nosocomiology
基金
浙江省社发基金资助项目(2015zj00034)
