Mandell L
McMaster University School of Medicine, Hamilton, Ontario, Canada.
J Antimicrob Chemother. 2000 Jul;46 Suppl T1:33-7. doi: 10.1093/oxfordjournals.jac.a020892.
The incidence of penicillin resistance in pneumococci is increasing in the USA, having risen from <5% before 1989 to >35% in 1997. There has also been a shift in the ratio of intermediate to high-level resistance from 3 or 4:1 to 2 or 1:1. Multidrug resistance and resistance to macrolides and fluoroquinolones in pneumococci is also a matter of concern. The implications for empirical treatment of respiratory tract infections are considerable. The potential of quinolones with activity against respiratory pathogens including pneumococci must be preserved by careful antimicrobial prescribing.
在美国，肺炎球菌对青霉素的耐药率正在上升，已从1989年前的<5%升至1997年的>35%。中、高水平耐药的比例也发生了变化，从3或4:1变为2或1:1。肺炎球菌的多重耐药以及对大环内酯类和氟喹诺酮类药物的耐药也是一个令人担忧的问题。这对呼吸道感染的经验性治疗具有重大影响。必须通过谨慎使用抗菌药物来保留喹诺酮类药物对包括肺炎球菌在内的呼吸道病原体的抗菌活性。
