OBJECTIVETo study the effect of β-lactamase (BLs) detection and β-lactam/β-lactamase inhibitor (BL/BLI) on the incidence of antibiotic-associated diarrhea (AAD) in children with severe bacterial pneumonia.

METHODSThe clinical data of the children with bacterial severe pneumonia were retrospectively studied. Of all the patients, 248 using amoxicillin/clavulanate but without BLs detection and 323 using amoxicillin (BLs negative) or amoxicillin/clavulanate (BLs positive) were used as the amoxicillin group; 208 patients using piperacillin/tazobactam but without BLs detection and 291 patients using piperacillin (BLs negative) or piperacillin/tazobactam (BLs positive) were used as the piperacillin group; and 191 patients using cefoperazone/sulbactam but without BLs detection and 341 patients using cefoperazone (BLs negative) or cefoperazone/sulbactam (BLs positive) were used as the cefoperazone group. The incidence and clinical symptoms of AAD between the undetected and detected BLs patients were compared.

RESULTSThe incidences of AAD in the amoxicillin, piperacillin and cefoperazone groups without BLs detection groups were significantly higher than those in the corresponding groups with negative or positive results of BLs detection (P<0.01). The durations of diarrhea, antibiotic use and hospitalization stay in AAD patients receiving BLs detection were shorter than in those without receiving BLs detection (P<0.01).

CONCLUSIONSIt is very important to detect BLs for reducing the incidence and relieving symptoms of AAD in children with severe bacterial pneumonia.