儿童噁唑烷酮类抗生素临床应用与精准治疗专家共识

doi:10.12372/jcp.2026.25e1047

摘要/Abstract

摘要：

噁唑烷酮类抗生素因对革兰阳性菌及结核分枝杆菌具有高度抗菌活性，临床应用日益广泛，但超说明书使用现象亦随之增多。成人领域已积累较为丰富的临床研究数据，但儿童数据相对有限，且生理特征及药代动力学特征与成人差异显著，如何实现该类药物在儿童患者中的合理应用，成为当前儿科医师关注的重要临床问题。为此，由全国34家医院的儿科感染、重症医学、血液肿瘤和临床药学等多学科专家组成工作组制定该共识，旨在规范噁唑烷酮类药物在儿童中的应用，强调精准给药策略，并为肝肾功能不全、体外膜肺氧合治疗等特殊儿童的药物使用及药物不良反应监测提供建议，为临床医师提供基于现有证据的决策支持，推动儿童患者的合理用药。

关键词: 噁唑烷酮类抗生素, 耐药菌感染, 药物不良反应监测, 合理用药, 儿童

Abstract:

Oxazolidinone antibiotics, due to their high antimicrobial activity against Gram-positive bacteria and Mycobacterium tuberculosis, are increasingly used in clinical practice, leading to a rise in off-label use. While substantial clinical research data exist in adult populations, pediatric evidence remains limited, with significant physiological and pharmacokinetic differences compared to adults. Addressing the rational use of these agents in pediatric patients has emerged as a critical clinical challenge. To address this, a multidisciplinary working group comprising experts in pediatric infectious diseases, critical care, hematology-oncology, and clinical pharmacy from 34 hospitals nationwide developed this consensus. The primary objectives are to standardize linezolid use in pediatric infections, emphasize therapeutic drug monitoring for precise administration, and provide recommendations for special populations (e.g., children with hepatic/renal dysfunction or ECMO therapy) as well as adverse event monitoring. This consensus aims to offer evidence-based decision support for clinicians and promote rational medication use in pediatric patients.

Key words: oxazolidinone antibiotics, drug-resistant bacterial infections, adverse drug reaction monitoring, rational drug use, child

中图分类号:

噁唑烷酮类抗生素儿童临床应用共识协作组, 中华医学会儿科学分会感染学组, 浙江省医学会儿科分会感染学组, 儿童少年健康与疾病国家临床医学研究中心. 儿童噁唑烷酮类抗生素临床应用与精准治疗专家共识[J]. 临床儿科杂志, 2026, 44(1): 1-16.

Subspecialty Pediatric Consensus Collaborative Group, Subspecialty Group of Infectious Diseases, Society of Pediatric, Chinese Medical Association, Subspecialty Group of Infectious Diseases, Society of Pediatric, Zhejiang Medical Association, National Clinical Research Center for Children and Adolescents' Health and Diseases. Expert consensus on the clinical application and individualized therapy of oxazolidinone antibiotics in children[J]. Journal of Clinical Pediatrics, 2026, 44(1): 1-16.

图/表 1

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推荐强度	证据等级	描述
A	Ⅰa	RCTs的系统评价
	Ⅰb	结果可信区间小的RCT
	Ⅰc	显示“全或无效应”的任何证据
B	Ⅱa	队列研究的系统评价
	Ⅱb	单个的队列研究（包括低质量的RCT，如失访率>20％者）
	Ⅱc	基于患儿结局的研究
	Ⅲa	病例对照研究的系统评价
	Ⅲb	单个病例对照研究
C	Ⅳ	病例系列报告、低质量队列研究和低质量病例对照研究
D	Ⅴ	专家意见（即无临床研究支持的仅依据基础研究或临床经验的推测）