Clinical Analysis Of Antibiotic Associated Diarrhea Secondary To Pneumonia In Infants

Objective By studying the related factors of antibiotic associated diarrhea in infants with bronchial pneumonia after treatment,and the possible factors affecting the severity of diarrhea,we hope to provide references for clinicians to formulate treatment plans and choose antibiotics.Methods A total of 266 infants and children diagnosed with"bronchopneumonia"were collected from the pediatric outpatient department of the first affiliated hospital of guangxi medical university from September 2017 to August 2018.The children were divided into the diarrhea group and the control group according to whether they had antibiotic associated diarrhea or not,and then the children in the diarrhea group were divided into the light diarrhea group and the severe diarrhea group according to the severity of diarrhea.The general data,types of antibiotics used,time of antibiotic treatment,combined use of antibiotics,length of stay,application of hormones,application of microecological agents and laboratory tests of the children were analyzed by statistical analysis.Results⑴In diarrhea group the median age was 8.5 months and 73.9%in 1-12months;In control group the median age was 12.5 months and 50.0%in 1-12months.There were statistically significant differences between the two groups(P<0.05).There was no significant difference between the diarrhea group and the control group in gender,residence and admission season(P>0.05).⑵In diarrhea group the median length of stay was 5.5 days and<7 days accounted for 66.3%;In control group the median length of stay was 5 days and<7 days accounted for 81.9%.There were statistically significant differences between the two groups(P<0.05).The diarrhea group application of probiotics accounted for 32.6%,the control group application of probiotics accounted for49.1%.There were statistically significant differences between the two groups(P<0.05).There was no statistical difference between the diarrhea group and the control group(P>0.05).⑶In diarrhea group the median duration of antibiotics was 7 days,and combined use of antibiotics accounted for 43.5%;In control group the median duration of antibiotics was 5.5 days,and combined use of antibiotics accounted for 21.8%.There were statistically significant differences between the two groups(P<0.05).There were statistically significant differences in diarrhea rates among different antibiotics(P<0.05).Among them,penicillin is 54.5%,macrolide is 50%,cephalomycin is 36.8%and cephalosporins is 34.8%.There was no statistical difference in the incidence of diarrhea among various cephalosporins(P>0.05).⑷In diarrhea group the median WBC in peripheral blood was 9.97×10~9/L,and the median of procalcitonin was 0.073 ng/ml;In control group the median WBC in peripheral blood was 8.20×10~9/L,and the median of procalcitonin was0.061 ng/ml.There were statistically significant differences between the two groups(P<0.05).There were no significant differences in neutrophils,hemoglobin,c-reactive protein,total protein and albumin between the diarrhea group and the control group(P<0.05).⑸Age,combined use of antibiotics,probiotics,and WBC in peripheral blood were independent factors affecting the antibiotic related diarrhea secondary to pneumonia in infants(P<0.05).The combination of antibiotics and high WBC count in peripheral blood were risk factors(OR>1),while the older patients(with a larger age of months)and probiotics were protective factors(OR<1).⑹In light diarrhea group the median age was 9 months,combined use of antibiotics accounted for 34.3%,application of probiotics accounted for 38.8%,the median WBC number in peripheral blood was 9.85×10~9/L;In severe diarrhoea group the median age was 5 months,combined use of antibiotics accounted for 68.0%,application of probiotics accounted for 16.0%,the median WBC number in peripheral blood was 11.9×10~9/L.There were statistically significant differences between the two groups(P<0.05).There were no significant differences in gender,duration of antibiotics,length of stay and procalcitonin between the light diarrhea group and the severe diarrhea group(P>0.05).Conclusion⑴Children with young age,long hospital stay,long duration of antibiotic application,increased WBC level,increased procalcitonin level and combination of antibiotics are prone to antibiotic-related diarrhea and diarrhea is more severe.⑵Probiotics can reduce the occurrence and severity of diarrhea.