Temple M E, Nahata M C
Infectious Disease and Pediatric Pharmacotherapy, College of Pharmacy, The Ohio State University, Columbus 43210, USA.
Ann Pharmacother. 2000 May;34(5):656-61. doi: 10.1345/aph.19315.
To review the most currently accepted treatment options for the treatment of listeriosis.
Clinical literature was accessed through MEDLINE (1966-October 1999). Key search terms included Listeria monocytogenes, food-borne illness, penicillins, fluoroquinolones, cephalosporins, and vancomycin.
Listeriosis is mainly a food-borne illness caused by L. monocytogenes; people most prone to the disease are pregnant women, newborns, elderly, and those with HIV or other diseases compromising immunity. Listeria infections are associated with a high mortality rate, and thus effective antibiotic treatment is essential. Although a variety of antibiotics have activity against the organism, ampicillin alone or in combination with gentamicin remains the treatment of choice. Some patients may require alternative therapies due to allergies or certain disease states. Second-line agents for these cases include trimethoprim/sulfamethoxazole, erythromycin, vancomycin, and the fluoroquinolones. Cephalosporins are not active against Listeria.
Ampicillin is currently the drug of choice for treating L. monocytogenes infections. Many antibiotics have been shown to be effective and are used as second-line agents. However, further study is required for some of the most recently introduced antibiotics, such as the fluoroquinolones, to determine their place in the treatment of Listeria infections.
综述目前治疗李斯特菌病最被认可的治疗方案。
通过MEDLINE（1966年至1999年10月）检索临床文献。关键检索词包括单核细胞增生李斯特菌、食源性疾病、青霉素、氟喹诺酮类、头孢菌素和万古霉素。
李斯特菌病主要是由单核细胞增生李斯特菌引起的食源性疾病；最易患该病的人群是孕妇、新生儿、老年人以及患有艾滋病毒或其他损害免疫力疾病的人。李斯特菌感染与高死亡率相关，因此有效的抗生素治疗至关重要。尽管多种抗生素对该病原体有活性，但单独使用氨苄西林或与庆大霉素联合使用仍是首选治疗方法。一些患者由于过敏或某些疾病状态可能需要替代疗法。这些病例的二线药物包括甲氧苄啶/磺胺甲恶唑、红霉素、万古霉素和氟喹诺酮类。头孢菌素对李斯特菌无活性。
目前氨苄西林是治疗单核细胞增生李斯特菌感染的首选药物。许多抗生素已被证明有效并用作二线药物。然而，对于一些最新引入的抗生素，如氟喹诺酮类，需要进一步研究以确定它们在李斯特菌感染治疗中的地位。
