老年患者应用氟喹诺酮类抗生素的不良反应临床分析

Clinical analysis of adverse reactions induced by fluoroquinolone antibiotics in elderly patients

中文关键词: 老年  感染性疾病  氟喹诺酮类抗生素  药物不良反应  影响因素

英文关键词: elderly  infectious disease  fluoroquinolone antibiotic  adverse drug reaction  influence factor

中文摘要:

      目的 观察老年患者应用氟喹诺酮类抗生素所发生的药物不良反应(ADR),分析不良反应的发生特点、规律及影响因素,为指导临床合理用药提供参考.方法 回顾性选取2023年1月—2024年12月西部战区总医院诊治的应用氟喹诺酮类抗生素治疗疾病的136例老年患者的临床资料,根据是否发生药物不良反应分为ADR组(n=68)和非ADR组(n=68).收集比较2组患者的临床相关资料,观察ADR累及的器官/系统及其临床表现,分析影响ADR发生的因素和ADR发生后对临床综合结局指标的影响.结果 老年患者应用氟喹诺酮类抗生素的药物不良反应主要累及皮肤或皮肤附件,临床表现以皮疹为主;其次累及胃肠系统,临床表现包括恶心呕吐等.2组患者临床基线资料比较,差异无统计学意义(P＞0.05);2组患者ADR史、联合用药、用药疗程＞7 d、用药剂量＞400 mg/d、是否合并肝肾功能不全等5个因素差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,ADR史、联合用药、用药疗程＞7 d是影响老年患者应用氟喹诺酮类抗生素发生ADR的独立危险因素(P＜0.05).ADR组的住院时长、住院费用均高于非ADR组,差异具有统计学意义(P＜0.05).结论 ADR史、联合用药、用药疗程＞7 d是影响老年患者应用氟喹诺酮类抗生素发生ADR的独立危险因素,临床应重点关注存在以上特征的老年患者人群,合理应用氟喹诺酮类抗生素,确保治疗的安全性和有效性.

英文摘要:

      Objective To observe adverse drug reactions(ADRs)associated with fluoroquinolone antibiotics in elderly patients,analyze their characteristics,patterns and influencing factors,and provide references for guiding rational clinical medi-cation use.Methods The clinical data from 136 elderly patients treated with fluoroquinolone antibiotics in General Hospital of Western Theater Command between January 2023 and December 2024 were retrospectively collected.Patients were divided into ADR group(n=68)and non-ADR group(n=68)based on the occurrence of ADRs.Their clinical data were collected and compared between the two groups.The organ/systems involved in ADRs and their clinical manifestations were observed.The factors influencing ADR occurrence and the impact of ADRs on comprehensive clinical outcome indicators were analyzed.Results ADRs from fluoroquinolone antibiotics in elderly patients primarily involved the skin and skin appendages,and the clinical manifestations were mainly rashes.The gastrointestinal system was the second most commonly affected,with manifesta-tions including nausea and vomiting.No statistically significant differences were found in baseline clinical characteristics be-tween the two groups(P＞0.05).There were statistically significant differences in five factors between the two groups,name-ly the history of ADRs,concomitant medication use,medication course＞7 days,medication dose＞400 mg/d,and presence of liver and kidney dysfunction(P＜0.05).Multivariate Logistic regression analysis revealed that history of ADRs,concomi-tant medication use,and treatment duration＞7 days were independent risk factors for ADR occurrence in elderly patients using fluoroquinolone antibiotics(P＜0.05).The hospital stays of the ADR group was significantly longer and hospitalization costs was higher than those of the non-ADR group(P＜0.05).Conclusion A history of ADRs,concomitant medication use,and treatment duration＞7 days are independent risk factors for ADRs in elderly patients receiving fluoroquinolone antibiotics.Clini-cians should pay special attention to elderly patients with these characteristics,ensure rational use of fluoroquinolone antibiotics,and prioritize treatment safety and effectiveness.