Mandell L A, Ball P, Tillotson G
McMaster Medical Unit, Henderson General Hospital, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada.
Clin Infect Dis. 2001 Mar 15;32 Suppl 1:S72-9. doi: 10.1086/319379.
The adverse drug reactions associated with antimicrobials have become a topic of major importance and concern in the last few years. Antimicrobial toxicity may take many forms, varying from mild, transient phenomena to dramatic, life-threatening events such as seizures or cardiac arrhythmias. We review the toxicity of antimicrobials in general and of the fluoroquinolones in particular and attempt to explain the adverse events by use of structure-adverse event relationships where possible. There are currently 5 main mechanisms that can be invoked to explain antimicrobial toxicity: direct effects, hypersensitivity, changes in microbial flora, drug interactions, and microbial lysis. The adverse drug reactions seen with fluoroquinolones are explained on the basis of these 5 mechanisms. The various organ systems affected by the fluoroquinolones are considered; then individual members of the fluoroquinolone class are reviewed. The unexpected and dramatic problems encountered with temafloxacin and trovafloxacin are discussed as well.
在过去几年中，与抗菌药物相关的药物不良反应已成为一个极为重要且备受关注的话题。抗菌药物毒性可能有多种形式，从轻微的、短暂的现象到严重的、危及生命的事件，如癫痫发作或心律失常。我们综述了一般抗菌药物的毒性，特别是氟喹诺酮类药物的毒性，并尽可能通过结构 - 不良事件关系来解释这些不良事件。目前有5种主要机制可用于解释抗菌药物毒性：直接作用、超敏反应、微生物菌群变化、药物相互作用和微生物裂解。基于这5种机制来解释氟喹诺酮类药物出现的药物不良反应。我们考虑了受氟喹诺酮类药物影响的各个器官系统；然后对氟喹诺酮类药物的各个成员进行了综述。还讨论了替马沙星和曲伐沙星所遇到的意外且严重的问题。
