Genné D, Kaiser L, Kinge T N, Lew D
Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland.
Clin Microbiol Infect. 2003 Sep;9(9):949-54. doi: 10.1046/j.1469-0691.2003.00679.x.
In order to determine the causes of treatment failure in community-acquired pneumonia (CAP) clinical trials, a MEDLINE search for all CAP studies published between 1990 and 1997 was performed. Prospective, randomized studies comparing the efficacy of two or more antibiotics in CAP were selected. Treatment failure was defined as persistent fever, deterioration of patient's condition, or a change in the prescribed antibiotic regimen. In 16% of the cases included in the clinical trials, the treatment of CAP is unsuccessful. A significant number of identified failure cases were owing to antibiotic side-effects. Resistant pathogens are an unusual cause of failure whatever the antibiotic used.
为了确定社区获得性肺炎（CAP）临床试验中治疗失败的原因，我们对1990年至1997年间发表的所有CAP研究进行了MEDLINE检索。选择了比较两种或更多种抗生素治疗CAP疗效的前瞻性、随机研究。治疗失败的定义为持续发热、患者病情恶化或规定抗生素治疗方案的改变。在纳入临床试验的病例中，16%的CAP治疗未成功。大量已确定的失败病例是由抗生素副作用导致的。无论使用何种抗生素，耐药病原体都是导致治疗失败的罕见原因。
