A Clinical Evaluation of Sulbactam/Ampicllin in the Treatment of Pediatric Infections

Sulbactam/Ampicillin 在小兒科感染症治療效果之臨床評估

黃立民(Li-Min Huang) ； 李慶雲(Chin-Yun Lee) ； 李明鎮(Ming-Jenn Lee) ； 許靜瑛(Ching-Ying Hsu) ； 劉清泉(Ching-Chuan Liu) ； 洪俊源(Jin-Yang Hong) ； 陳中明(Jong-Min Chen)

《Acta Paediatrica Sinica》 30卷2期 (1989/04) Pp. 87-93

摘要

我們利用Sulbactam/ampicillin一共治療了42次小兒感染。其中有9次蜂窠組織炎、9次尿道感染、5次頸部化膿性淋巴結炎、4次腦膜炎、2次肋膜腔積膿、2次骨髓炎、2次敗血症、1次表皮癤、1次肛門週圍膿瘍、1次扁桃腺週圍組織炎、1次沙門氏菌感染、1次志賀桿菌病、1次腹膜炎、1次化膿性甲狀腺炎、1次細菌性心內膜炎及1次齦膿瘍。
分離出之致病菌為大腸桿菌8例、金黃色葡萄球菌6例、肺炎雙球菌3例、草綠色鏈球菌2例、流行感冒桿菌2例、白色葡萄球菌1例、Bacteroides fragilis 1例、 Enterobacter agglomerans 1例、D族沙門氏菌1例、宋內氏志賀桿菌1例、Acinetobacter calcoaceticus l例、Enterobacter cloacae l例、A族溶血性鏈球菌1例，此外有4例是多菌性混合感染。
在41個臨床上可評估的病例中有39例痊癒，占百分之九十五。細菌學上可評估的34例病人均可徹底清除致病菌。
5個病人在治療中出現副作用。1例出現斑丘皮疹，1例有溶血性貧血，1例用藥中稀便，1例有腹瀉，1例有肝功能異常及白血球數目降低。不過所出現之副作用均持續不長，不致影響用藥。
本研究結果顯示Sulbactam/ampicillin對於治療超過新生兒期之一般小兒科感染具有良好療效，且相當安全。

並列摘要

We have treated 42 episodes of pediatric infections with sulbactam/ampicllin since 1987. Included were 9 cellulitis, 9 urinary tract infections, 5 cervical lymphaenitis, 4 meningitis, 2 thoracic empyema, 2 osteomyelitis, 2 sepsis, 1 furuncle, 1 perianal abscess, 1 dental abscess, 1 peritonsillitis, 1 salmonellosis, 1 shigellosis, 1 peritonitis, 1 suppurative thyroiditis, 1 infective endocarditis.
Responsible pathogens were Escherichia coli in 8, Staphylococcus aureus in 6, Hemophilus influenzae in 2, Streptococcus pneumoniae in 3, Streptococcus viridans in 2, Staphylococcus epidermidis in 1, Bacateroidesfragilis in 1, Salmonella Dl in 1, Shigella sonnei in 1, Klebsiella pneumoniae in 1, Enterobacter agglomerans in 1, Acinetobacter calcoaceticus in 1, Enterobacter cloacae in 1, group A beta-hemolytic streptococcus in 1, and polymicrobial infection in 4 cases.
Thirty-nine out of 41 (95%) clinically evaluable patients cured and all (34/34) bacteriologically evaluable patients eradicated their pathogens after treatment with sulbactam/ampicillin.
Side reactions were seen in five patients; one maculopapular skin rash, one hemolytic anemia, two diarrhea, and one liver function impairment plus leukopenia. All these reactions were transient and did not require interruption of therapy.
These results indicate that sulbactam/ampicillin is safe and effective in the treatment of common pediatric infections beyond the neonatal period.