Pichicero M
Elmwood Pediatric Group, University of Rochester Medical Center, Rochester, New York 14642, USA.
J Int Med Res. 2000;28 Suppl 1:25A-36A.
Poor compliance with standard antibiotic regimens of 7 - 10 days' duration used in the treatment of acute upper respiratory tract infections contributes significantly to treatment failure. Patients fail to complete the recommended course of treatment, stopping once symptoms have resolved, which is typically within 2 - 5 days. Accumulating evidence from a large number of prospective clinical studies suggests that shortened courses of treatment may be as, or more, effective than conventional regimens of longer duration. As an example, a study comparing 5 days of cefuroxime axetil therapy with either 10 days of cefuroxime axetil or amoxycillin/clavulanate showed no differences in rates of clinical cure, bacteriological eradication and recurrence in paediatric patients with either acute otitis media or sinusitis. Shortened-course therapy with agents such as cefuroxime axetil has the potential to improve patient compliance and so reduce the rate of clinical failure and the emergence of resistant strains. Other potential benefits include fewer side-effects, improved patient satisfaction and lower treatment costs.
在治疗急性上呼吸道感染时,患者对7至10天标准抗生素疗程的依从性差是导致治疗失败的重要原因。患者未能完成推荐的治疗疗程,一旦症状缓解(通常在2至5天内)就停止用药。大量前瞻性临床研究积累的证据表明,缩短疗程可能与传统的较长疗程一样有效,甚至更有效。例如,一项将5天头孢呋辛酯治疗与10天头孢呋辛酯或阿莫西林/克拉维酸治疗进行比较的研究表明,患有急性中耳炎或鼻窦炎的儿科患者在临床治愈率、细菌清除率和复发率方面没有差异。使用头孢呋辛酯等药物进行短疗程治疗有可能提高患者的依从性,从而降低临床失败率和耐药菌株的出现率。其他潜在益处包括副作用更少、患者满意度提高和治疗成本降低。