摘要
目的根据眼内炎病因,探讨其病原体检测和抗菌药物使用情况,为临床规范使用抗菌药物治疗眼内炎提供合理建议。方法回顾性分析2017年本院18例眼内炎病例临床诊疗过程,对其病因、病原体培养及抗菌药物治疗方案进行分析讨论。结果现临床眼内炎病原体培养仍存在检出率低、检出时间滞后等问题。眼内炎抗菌药物使用分为局部抗感染治疗和局部联合全身抗感染治疗两大类,局部用药有外用和玻璃体内注射两种方式,外用可选用左氧氟沙星滴眼液等,玻璃体内注射可选万古霉素、头孢他啶等;全身用药有静脉注射和口服两种方式,可选用万古霉素、利奈唑胺、头孢他啶及莫西沙星等;抗真菌治疗可选伏立康唑、两性霉素B等。结论在眼内炎治疗过程中,病原体的培养应尽快且准确,抗菌药物的使用应建立明确的规程。
Objective According to the etiology of endophthalmitis,investigating the detection of pathogens and the use of antibiotics,for providing reasonable recommendations for the clinical use of antibiotics to treat endophthalmitis.Methods Review of clinical diagnosis and treatment of 18 endophthalmitis cases(18 eyes)in our hospital in 2017,by analyzing the etiology,pathogen and antibiotic treatment schemes.Results In the treatment of endophthalmitis,there is still a low detection rate of clinical endophthalmitis pathogen culture,and the detection time lags behind the treatment.The use of antibiotics for endophthalmitis can be divided into local and local combined systemic anti-infective treatments.Local treatment for topical and intravitreal injection.Topical treatment can be selected from levofloxacin eye drops etc,intravitreal injection can be selected from vancomycin,ceftazidime,etc.Systemic anti-infective treatments can be selected from vancomycin,linezolid,ceftazidime,moxifloxacin etc.Voriconazole,amphotericin B or the like can be used for antifungal treatment.Conclusion In the treatment of endophthalmitis,the cultivation of pathogens should be as fast and accurate as possible,and the use of antibiotics should establish clear procedures.
作者
潘慧
朱蓓琳
张渊
张其锵
方忠宏
PAN Hui;ZHU Bei-lin;ZHANG Yuan;ZHANG Qi-qiang;FANG Zhong-hong(Department of Clinical Pharmacy,Shanghai General Hospital,Shanghai 200080,China;School of Pharmacy,Chongqing Medical University,Chongqing 409912,China;Department of Pharmacy,Jinshan Hospital Affiliated to Fudan University,Shanghai 201508,China)
出处
《世界临床药物》
CAS
2019年第3期200-204,共5页
World Clinical Drug
基金
国家自然科学基金项目(81703597)
上海市卫计委重要薄弱学科建设-临床药学(2016ZB0302)
关键词
眼内炎
病因
病原体
抗菌药物
endophthalmitis
pathogeny
pathogen
antibacterials
