阿莫西林克拉维酸钾联合第三代头孢类抗菌药治疗新生儿肺炎的临床效果及其对肠道菌群的影响

来源期刊：广州医药 | 176-180 发布时间：2024-03-06 收稿时间：2025/11/13 18:51:05 阅读量：29

作者：: 蒋伟峰,

刘雨露,

王战胜,

关键词：: 阿莫西林克拉维酸钾第三代头孢类抗菌药新生儿肺炎肠道菌群; amoxicillin clavulanate potassium third generation cephalosporin antibiotics neonatal pneumonia intestinal microbiota

DOI：: 10.3969/j.issn.1000-8535.2024.02.013

收稿时间：: 2023-05-08
修订日期：
接收日期：
引用总数：: 3

目的分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组（n=50）及参照组（n=50）。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义（P>0.05）,治疗后两组患儿的降钙素原（procalcitonin,PCT）、C-反应蛋白（C-reactive protein,CRP）、白细胞计数（white blood cell count,WBC）、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善（P<0.05）,其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率（94.00%）与参照组的临床有效率（86.00%）比较差异无统计学意义（P>0.05）;两组患儿的不良反应发生率比较差异无统计学意义（P>0.05）,但其中研究组腹泻的发生率高于参照组（P<0.05）。结论在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药（头孢他啶）的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。

Objective To analyze the application effect of amoxicillin clavulanate potassium combined with third-generation cephalosporin antibiotics in children with neonatal pneumonia and its impact on the intestinal microbiota．Methods From February 2021 to November 2022,100 newborns with pneumonia who received relevant treatment in the Department of Neonatology at the First People’s Hospital of Shangqiu City were randomly divided into a study group（n=50）and a reference group（n=50）using a simple randomization method．Routine treatment was provided for neonatal pneumonia in the reference group,and on this basis,a combination treatment of amoxicillin,clavulanate potassium,and third-generation cephalosporin antibiotics was applied on the study group patients．After treatment,the serum factor levels,intestinal colony status,clinical efficacy,and incidence of adverse reactions were compared between the two groups of children．Results Before treatment,there were no statistically significant differences in serum factor levels and intestinal microbiota between the two groups of children（P>0.05）．After treatment,the levels of procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell count（WBC）,Enterococcus,Enterobacter,Bifidobacterium,and Lactobacillus in the two groups of children improved（P<0.05）,with the levels of PCT,CRP,WBC,the number of Enterococcus,Bifidobacterium,and Lactobacillus in the study group was lower than that in the reference group,while the number of Enterobacter in the study group was higher．There was no statistically significant difference（P>0.05）in the clinical response rate between the study group（94.00%）and the reference group（86.00%）．There was no statistically significant difference in the incidence of adverse reactions between the two groups of children（P>0.05）,but the incidence of diarrhea in the study group was higher than that in the reference group（P<0.05）．Conclusions The clinical efficacy of amoxicillin clavulanate potassium alone and amoxicillin clavulanate potassium+third-generation cephalosporin antibiotics（ceftazidime）in the treatment of newborns with pneumonia is comparable．Although the combination therapy can significantly reduce the number of bacteria in the body of children and improve serum factor levels,it is more prone to complications of diarrhea．In order to reduce drug resistance,separate medication should be appropriately used．

1、 MATHUR N B,MURUGESAN A.Comparison of four days versus seven days duration of antibiotic therapy for neonatal pneumonia:A randomized controlled trial[J].Indian J Pediatr,2018,85(11):963-967.

2、杨风敏. 不同用药方案治疗新生儿肺炎的效果及对患儿肠道微生态的影响[J].河南医学研究,2019,28(5):824-825.

3、崔磊. 联合药物治疗新生儿肺炎的临床效果及对患者消化系统的影响分析[J].吉林医学,2021,42(10):2451-2452.

4、刘萍,赫文静.聚焦解决模式在青霉素联合头孢菌素治疗新生儿肺炎中的应用效果及对新生儿肠道微生态的影响[J].临床医学研究与实践,2020,5(35):190-192.

5、 ALANEZI G,ALMULHEM A,ALDRIWESH M,et al.Atriple antimicrobial regimen for multidrug-resistant klebsiella pneumonia in a neonatal intensive care unit outbreak:A case series[J].J Infect Public Health,2022,15(1):138-141.

6、杨天珠,张美霞.氨溴索联合抗生素治疗新生儿肺炎的疗效及对新生儿肺功能的影响[J].临床医学,2021,41(2):101-103.

7、雷培瑜,雷婧,王洁.络酸梭菌二联活菌对肺炎合并抗生素相关性腹泻患儿肠道菌群及炎症、免疫指标的影响[J].中国基层医药,2020,27(15):1858-1861.

8、邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].第5版.北京:人民卫生出版社,2021:242.

9、王祥,翁晓文,王军.青霉素联合头孢菌素对新生儿肺炎疗效及肠道微生物环境的影响[J].中国医药导报,2021,18(20):82-85.

10、柳晓兴,柳立娟,魏敏,等.阿莫西林和头孢他啶联合治疗新生儿肺炎的临床效果及对患儿肠道菌群的影响[J].内科,2022,17(3):316-318.

11、 ALARJANI K M,ALMUTAIRI A M,ALQAHTANY F S,et al.Methicillin and multidrug resistant pathogenic Staphylococcus aureus associated sepsis in hospitalized neonatal infections and antibiotic susceptibility[J].Infect Public Health,2021,14(11):1630-1634.

12、郭倩,张靖,惠晓君,等.乙酰半胱氨酸联合头孢唑肟治疗新生儿肺炎的临床研究[J].现代药物与临床,2022,37(4):778-780.

1、万妮莎,汪甜甜,石禹阳,等.阿莫西林克拉维酸钾不同配比的抑菌活性及对肺炎大鼠肠道菌群的影响[J].中国处方药,2025,23(03):29-37.

2、罗裕,罗伟平,彭晓青,等.基于网络药理学与分子对接技术研究白头翁汤治疗细菌性痢疾的潜在活性成分及作用机制[J].广州医药,2025,56(02):216-227.DOI:10.20223/j.cnki.1000-8535.2025.02.012.

3、张小敏.注射用阿莫西林钠克拉维酸钾在小儿肺炎中的应用效果分析[J].中国实用医药,2025,20(06):6-10.DOI:10.14163/j.cnki.11-5547/r.2025.06.002.