中国临床药学杂志

目的 分析抗菌药物相关性脑病发生的规律及临床特征，为临床预防、早期识别及处理抗菌药物相关性脑病提供参考。方法 收集2021年1月至2024年1月住院期间发生抗菌药物相关性脑病的病例77例，对病例的年龄、性别、用药情况、临床表现、处理及转归等临床相关因素进行分析。结果 77例抗菌药物相关性脑病病例中，男性50例（占64.94%），女性27例（占35.06%）；年龄（77.52±7.07）岁，20～89岁，其中年龄为80～89岁的病例占比最高（占53.25%）。77例病例使用的抗菌药物以头孢菌素类药物为主（占54.55%）；抗菌药物相关性脑病的临床表现主要为幻觉、躁动不安、嗜睡、神志淡漠、胡言乱语、亢奋、肢体不自主抖动等。出现神经、精神症状的时间为使用抗菌药物后（5.23±2.50）d，其中出现在使用抗菌药物后4～6 d的病例占比最高（占42.86%）；症状消失时间多为停药或减量后1～3 d（占66.23%）。77例病例中有42例进行了抗菌药物血药浓度监测，其中16例（占38.10%）提示抗菌药物血药浓度偏高。结论 在使用抗菌药物过程中，临床应关注抗菌药物相关性脑病的发生情况，进行预防、早期识别和处理，加强抗菌药物血药浓度监测，降低不良反应发生风险。

AIM To analyze the occurrence patterns and clinical characteristics of antibiotic-associatedencephalopathy and provide a basis for prevention, early identification, and treatment of antibiotic-associatedencephalopathy. METHODS A retrospective analysis was conducted on 77 patients of antibiotic-associatedencephalopathy that occurred during hospitalization from January 2021 to January 2024. The clinical factors were analyzedincluding patients' age, gender, medication details, clinical manifestations, interventions, and outcomes. RESULTSAmong the 77 patients with antibiotic-associated encephalopathy, 50 were males(64.94%) and 27 were females(35.06%),aged between 20 and 89 years, with an average age of(77.52±7.07) years. Specifically, 41 patients aged between 80 and 89years were accounting for the largest proportion(53.25%). Cephalosporins(54.55%) were the main antibiotics that causedencephalopathy. Clinical manifestations of encephalopathy primarily included hallucination, restlessness, lethargy, apathy,gibberish, hyperexcitability, and involuntary limb-shaking. The average time of occurrence of neuropsychiatric symptomswas(5.23±2.50) days after using antibiotics, most of which occurred in 4-6 days(accounting for 42.86%). Most of thesymptoms disappeared within 1-3 days after drug withdrawal or dose reduction(accounting for 66.23%). Therapeutic drugmonitoring was performed in 42 patients, with 38.10%(16/42) demonstrating elevated serum antibiotic concentrations.CONCLUSION Attention should be paid to the occurrence of antibiotic-associated encephalopathy, prevention, earlyidentification, and treatment. Efforts should be made to enhance the monitoring of antibiotics drug concentrations in theblood to reduce the risk of adverse reactions.