儿童使用抗生素的注意事项.doc

4儿童使用抗生素的注意事项抗生素是临床上常用药物，使用范围广，使用频率也较高。但随着抗生素的大量应用，滥用现象也不断发生。世界卫生组织调查显示，目前我国已经成为世界上滥用抗生素最为严重的国家之一。为使滥用现象得到根本遏制，大家需要了解以下几个问题。1.什么是炎症？抗生素，中国人习惯叫“消炎药”，作为家庭的最常备药，人们只要有点儿头疼脑热，都会习惯性地吃上几片。事实上，抗生素是具有 杀灭或抑制细菌生长的药物。而医学意义上的炎症是指各种因素导致机体的一种防护性反应，表现为红肿热痛。消炎药是针对炎症的，比如常用的消炎痛、芬必得、 扶他林、消炎镇痛药等。所以抗生素不是消炎药，只有在有细菌感染时才能使用抗生素。2.常用的抗生素有哪些？青霉素类：青霉素、阿莫西林(阿莫仙)；头孢菌素类(先锋霉素)：头孢呋辛酯(伏乐新)、头孢克洛(希刻劳)；大环内 酯类：红霉素、阿奇霉素(希舒美)、克拉霉素；喹诺酮类(沙星类)：左氧氟沙星(利复星)、莫西沙星(拜复乐)；氨基糖苷类：庆大霉素、链霉素、阿米卡 星。3.感冒了需要用抗生素吗？大多数感冒都是病毒引起的，病毒性感冒、流感、麻疹风疹，腮腺炎等都属于病毒感染，不需要使用抗生素。病毒性感冒有自愈性，并没有什么有效的药物，只是对症治疗：多喝水、注意休息、服用缓解症状的感冒药物。4.是不是输液抗炎比口服效果好？多数老百姓认为输液比口服好。输液确实起效快，但副作用多且风险大。2011年国家药品不良反应监测报告 显示，在所有的药品不良反应报告中静脉输液药物引起的不良反应占56%，在严重不良反应中，静脉输液药物占到了73%。可以说，输液是最不安全的给药方 式。一旦有不良反应，输液带来的后果比口服和皮下注射更严重，因为口服药如果有不良反应可以洗胃，皮下注射的药物吸收需要一定的时间，这样都能给急救赢得 一定的时间。常输液还会降低免疫力。输液的药物直接进入血液循环，没有经过胃肠，省略了体液免疫和细胞免疫环节，如果人们不管大病小病首选输液，长此以往，必然降低人体自身免疫力。5.抗生素种类越多，效果越好吗？不是，只有在严重感染，多部位感染和混合感染时，才考虑联合两种以上的抗生素。一般情况下，能用一种时，不用两种。6.抗生素应该用多长时间？许多人患病后，病情较重时尚能按时按量服药，一旦病情缓解，服药便随心所欲。要知道抗菌药物的药效依赖于有效的血药 浓度，如达不到有效的血药浓度，不但不能彻底杀灭细菌，反而会使细菌产生耐药性；对于确属细菌感染的病，要根据引起疾病的不同菌种选择相应的药物；如果使 用某种抗生素的疗效暂时不好，首先应当考虑用药疗程是否足够。即便见了效，也应该在医生的指导下服够必需的周期，不要频繁更换药品。因为用药起效需要一个 过程，频繁换药，反而造成耐药，菌群失调。7.价格贵的抗生素一定比便宜的好吗？每种抗生素都有自身的特性，优势劣势各不相同，因病、因人、因致病菌选择，坚持个体化，以价格判断药物好坏没有道理。药品并不是“便宜没好货，好货不便宜”的普通商品，只要用之得当，几分钱的药物也可能达到药到病除的疗效。有时候，老药比新药“物美价廉”：药效稳定，价格便宜，不良反应明确；对于军团菌和支原体感染的肺炎，红霉素具有相当好的疗效，而价格非常高的碳青霉烯类的抗生素和第三代头孢菌素对付这些病就不如红霉素。8.儿童使用抗生素的注意事项有哪些？儿童输液占到整个输液93%，但儿童上呼吸道感染，感冒和婴幼儿腹泻多是病毒引起，用抗菌药物没有作用。如果一定 要用，坚持以下几点。注意剂量。按照病情和体重计算剂量；按照说明书用药 6小时一次，8小时1次或者12小时1次。不要随意更改，加减药物。否则会导致毒副作用，影响治疗效果。不能随便联合用药。两种或两种以上一起使用，除非 医生判断有严重的或者混合感染才可以。密切关注副作用的发生。如过敏、皮疹 、药物热、 哮喘等。按照医生的要求做检查，及时发现肝肾功能的损害。如出现耳鸣等过敏严重反应应当立即停药，父母还要记住这种药的名字，以免以后再次使用，造成严重 伤害。避免使用禁用的抗菌药物，如对肾有毒性的氨基糖苷类(庆大霉素，阿米卡星等)，喹诺酮类(左氧氟沙星、环丙沙星等)影响骨骼发育，18岁以下禁用。 四环素类(米诺环素等)影响牙齿的发育，8岁以下儿童禁用。9.服用抗菌药时，可以饮酒吗？使用抗菌药期间饮酒，有时会引发双硫仑样反应，表现为面部潮红、眼结膜充血、视觉模糊、头颈部血管剧烈搏动或搏 动性头痛、头晕，恶心、呕吐、出汗、口干、胸痛、心肌梗塞、急性心衰、呼吸困难、急性肝损伤，惊厥及死亡等。可引发双硫仑样反应最常见的抗菌药是头孢菌素 类。Antibiotics is commonly used clinical drugs, use range, use frequency is higher also. But along with the application of antibiotics abuse phenomenon also occur repeatedly. The world health organization survey, at present our country has become one of the most serious abuse of antibiotics in the world. To get basic stem abuse, you need to know the following questions.1. What is inflammation? Antibiotics, Chinese people used to call anti-inflammatory drugs, as the most regular family medicine, people, as long as a bit of a headache brain hot will habitually eating a few pieces. In fact, antibiotics is a drug to kill or inhibit the growth of the bacteria. Inflammation and medical sense refers to various factors lead to the body of a protective reaction, characterized by redness and swelling thermal pain. Anti-inflammatory drugs for inflammation, such as commonly used indomethacin, he will receive, helped him Lin, anti-inflammatory analgesic, etc. So not anti-inflammatory drugs, antibiotics can only use of antibiotics in a bacterial infection.2. What are the commonly used antibiotics? Penicillin class: penicillin, amoxicillin (amor fairy); Cephalosporin class (cephradine) : cefuroxime ester (new) FuLe, cefaclor, carved law); Large ring lactone class: erythromycin, azithromycin, shu mei), clarithromycin; Quinolone class (class) characters: levofloxacin (the company), moxifloxacin (after worship music); Aminoglycoside: gentamycin, streptomycin, amikacin.3. Caught a cold need to use antibiotics? Most colds are caused by a virus, viral colds, flu, measles, rubella, mumps and other belong to virus infection, do not need to use antibiotics. Viral cold self-healing, no effective drug, only symptomatic treatment, drink water more, pay attention to rest, relieve symptoms of a cold medications.4. The infusion than oral anti-inflammatory effect is good? Most people believe that infusion is better than oral. Infusion does work fast, but more side effects and risks. The 2011 national adverse drug reaction monitoring report shows that in all of the adverse drug reactions report drug-induced adverse reactions (56%), intravenous fluids in serious adverse reactions, intravenous infusion drugs accounted for 73%. Infusion is, as it were, the most unsafe to prescription type. Once has the adverse reaction, the consequences of the infusion more serious than oral and subcutaneous injection, because oral medications if have adverse reactions to gastric lavage, it takes time to subcutaneous injection of drug absorption, it can give first aid to win a certain amount of time.Often infusion reduced immunity. Infusion of the drug directly into the blood circulation, without gastrointestinal, omitted the humoral immunity and cellular immunity, if people regardless of a serious illness ailment preferred infusion, for a long time hence, will reduce the bodys own immune system.5. The more kinds of antibiotics, the better the results? Not only in severe infection, many site infection and mixed infection, to consider joint two or more of the antibiotics. In general, can use one, not two.6. Antibiotics should be used for how long? Many people fell ill after illness heavier fashion can proper dose on time, once the remission, medication and follow ones inclinations. Want to know the efficacy of antimicrobial drugs is dependent on the effective blood drug concentration, such as short of effective blood drug concentration, not only can not completely kill bacteria, it will make the bacteria resistant; For it is a bacterial infection disease, want to choose according to different strains of diseases caused by the corresponding drugs; If make with some antibiotics, the efficacy of temporary is not good, should first consider drug treatment will be enough. Even see the effect, under the guidance of doctors take enough necessary cycle, not to replace drugs. Because the drug effect needs a process, frequent switching, prompting resistant, dysbacteriosis.7. Expensive antibiotics must be better than cheaper? Advantages and disadvantages each antibiotics has its own features, each are not identical, due to illness, choice of people, and by pathogenic bacteria, adhere to the individual, in order to judge the drug price makes no sense. Medicines are not cheap goods is not good, good stuff is not cheap ordinary goods, as long as used properly, the effect of a few cents of drugs may also be to be done.Sometimes, older drugs than new affordable : efficacy of stable, cheap, adverse reactions; For legionella bacteria and mycoplasma pneumonia, erythromycin has fairly good curative effect, but the price is very high carbon penicillium alkene and the third generation of cephalosporin antibiotics against the disease than erythromycin.What are the precautions for 8. Childrens use of antibiotics? Infusion of the whole transfusion 93% children, but children of the upper respiratory tract infections, colds and diarrhea is virus causes more, use of antimicrobial agents. If must use, insist on the following points. Pay attention to the dosage. According to the condition and weight calculation dose; According to the instruction manual was a 6 hours, 8 hours 1 1 or 12 hours. Dont change, add and subtract. Otherwise it will cause side effects, affects the treatment effect. Cant literally combination. Use of two or more than two unless a doctor judge has serious or mixed infection. Pay close attention to the occurrence of side effects. If irritation, rashes, drug fever, asthma, etc. Do check, according to the requirements of the doctor found that damage of liver and kidney function in a timely manner. If appear tinnitus shall immediately stop drug allergy serious reactions, such as parents and remember the name of the medicine, in order to avoid to use again later, causing serious damage. Avoid using disable antibacterial