Schaad U B
University Children's Hospital, Basel, Switzerland.
J Int Med Res. 2004 Jan-Feb;32(1):1-13. doi: 10.1177/147323000403200101.
This review evaluates studies published between January 1997 and August 2003 comparing clinical outcome and bacteriological eradication rates for patients with acute streptococcal tonsillopharyngitis treated with penicillin or other antimicrobial agents. Studies were identified using MEDLINE, and clinical outcome and bacteriological eradication at end of treatment and 2 weeks after end of treatment were ascertained. Any longer-term follow-up was also noted, along with treatment-related adverse events and compliance. Clinical efficacy rates between penicillin and comparator antibiotics were generally high and similar. Bacterial eradication rates were more variable and, 2 weeks after treatment, ranged from 64% to 93% for penicillin and 31% to 98% for comparators. Simpler dosing schedules and shorter therapy durations produced higher compliance rates. This review highlights the similarities and differences between treatment with penicillin and a wide range of comparator antibiotics. Therapy for acute group A streptococcal pharyngitis should combine excellent clinical efficacy, high bacteriological eradication rates, good tolerance and a simple, convenient dosing regimen.
本综述评估了1997年1月至2003年8月间发表的研究，这些研究比较了用青霉素或其他抗菌药物治疗的急性链球菌性扁桃体咽炎患者的临床结局和细菌清除率。通过医学文献数据库（MEDLINE）检索相关研究，并确定治疗结束时及治疗结束后2周的临床结局和细菌清除情况。还记录了任何长期随访情况，以及与治疗相关的不良事件和依从性。青霉素与对照抗生素之间的临床有效率总体较高且相似。细菌清除率的差异更大，治疗后2周，青霉素的清除率为64%至93%，对照抗生素为31%至98%。更简单的给药方案和更短的治疗疗程产生了更高的依从率。本综述强调了青霉素与多种对照抗生素治疗之间的异同。A组急性链球菌性咽炎的治疗应兼具出色的临床疗效、高细菌清除率、良好的耐受性以及简单方便的给药方案。
