Hoepelman I
Universitair Medisch Centrum Utrecht, afd. Interne Geneeskunde & Infectieziekten, Heidelberglaan 100, 3584 CX Utrecht.
Ned Tijdschr Geneeskd. 2004 Oct 23;148(43):2115-21.
Since their introduction in the seventies, the fluoroquinolones have gained an important place in the treatment of Gram-negative infections. Modifications in their structure have led to a number of newer agents with improved activity against Gram-positive microorganisms. Among these new agents are gatifloxacin, levofloxacin and moxifloxacin, which have been registered in The Netherlands. These new fluoroquinolones are promoted by the manufacturers for use in respiratory tract infections, notably in community-acquired pneumonia. Studies have shown that these agents may be somewhat more effective than the current antibiotics in use in The Netherlands for community-acquired pneumonia. Given the fact that penicillin resistance among pneumococci hardly occurs in The Netherlands and the severe risk of the development of resistance in both Gram-positive and Gram-negative microorganisms when the new fluoroquinolones are used, their area of indication would currently seem to be limited.
自20世纪70年代问世以来,氟喹诺酮类药物在革兰氏阴性菌感染的治疗中占据了重要地位。其结构的改良催生了许多对革兰氏阳性微生物活性增强的新型药物。这些新型药物包括加替沙星、左氧氟沙星和莫西沙星,已在荷兰注册。这些新型氟喹诺酮类药物被制造商推广用于呼吸道感染,尤其是社区获得性肺炎。研究表明,这些药物在治疗荷兰社区获得性肺炎方面可能比目前使用的抗生素更有效。鉴于荷兰肺炎球菌对青霉素的耐药性几乎不存在,且使用新型氟喹诺酮类药物时革兰氏阳性菌和革兰氏阴性菌均有产生耐药性的严重风险,它们目前的适应证范围似乎较为有限。