Petrova M S, Shakirova R G, Antonova N A, Feoktistova G N
Antibiot Khimioter. 1992 Nov;37(11):40-3.
The data accumulated within the last years required revision of the indications to the use of antibiotics in treatment of pertussis. One of the aims of antibiotic therapy in pertussis was to prevent colonization of B. pertussis in the respiratory tracts. With that end in view the choice of antibiotics should be limited by those, to which the pathogen is the most sensitive i.e. erythromycin, ampicillin and augmentin. Comparative efficacy of erythromycin and ampicillin during the first 2 weeks of the disease was studied in 79 infants at the age not older than 1 year with pertussis and it was shown that erythromycin was advantageous by its therapeutic activity and less side effects. Expedience of the antibiotic therapy during the spastic period for providing a preventive effect on development of bronchopulmonary complications was studied in 201 patients with pertussis. No preventive effect of the antibiotics on development of the bronchopulmonary complications defined by the secondary bacterial flora was recorded. In the group of the patients treated with the antibiotics prophylactically (group 1) the complications were 2.6 times more frequent than in the patients treated with pathogenetic agents alone (group 2). Intrahospital pneumonia developed in 8.9 per cent of the patients in group 1 and in 1.5 per cent of the patients in group 2. Therefore, antibiotics should not be used at the late periods of pertussis for prophylaxis of secondary bacterial complications.
过去几年积累的数据要求修订抗生素在百日咳治疗中的使用指征。百日咳抗生素治疗的目标之一是防止百日咳杆菌在呼吸道定植。鉴于此,抗生素的选择应限于病原体最敏感的那些,即红霉素、氨苄西林和阿莫西林克拉维酸钾。对79名1岁及以下患百日咳的婴儿研究了疾病最初2周内红霉素和氨苄西林的比较疗效,结果表明红霉素在治疗活性方面更具优势且副作用更少。对201名百日咳患者研究了痉挛期抗生素治疗对预防支气管肺并发症发生的合理性。未记录到抗生素对由继发细菌菌群引起的支气管肺并发症的发生有预防作用。在预防性使用抗生素的患者组(第1组)中,并发症的发生率比仅使用病因治疗药物的患者组(第2组)高2.6倍。第1组8.9%的患者发生了院内肺炎,第2组为1.5%。因此,在百日咳后期不应使用抗生素预防继发性细菌并发症。