Buckingham Steven C
Department of Pediatrics, Division of Infectious Disease, University of Tennessee Health Science Center and Children's Foundation Research Center at Le Bonheur Children's Medical Center, Memphis, Tennessee, USA.
Paediatr Drugs. 2005;7(3):163-76. doi: 10.2165/00148581-200507030-00003.
Ticks can transmit bacterial, protozoal, and viral infections to humans. Specific therapy is available for several of these infections. Doxycycline is the antimicrobial treatment of choice for all patients, regardless of age, with Rocky Mountain spotted fever, human monocytic ehrlichiosis, or human granulocytic ehrlichiosis. Chloramphenicol has been used to treat these infections in children but is demonstrably inferior to doxycycline. In patients with Mediterranean spotted fever, doxycycline, chloramphenicol, and newer macrolides all appear to be effective therapies. Therapy of Lyme disease depends on the age of the child and stage of the disease. For early localized disease, amoxicillin (for those aged <8 years) or doxycycline (for those aged >/=8 years) is effective. Doxycycline, penicillin V (phenoxymethylpenicillin) or penicillin G (benzylpenicillin) preparations, and erythromycin are all effective treatments for tick-borne relapsing fever. Hospitalized patients with tularemia should receive gentamicin or streptomycin. Doxycycline and ciprofloxacin have each been investigated for the treatment of tularemia in outpatients; however, these agents do not yet have established roles in the treatment of this disease in children. Combination therapy with clindamycin and quinine is preferred for children with babesiosis; the combination of azithromycin and atovaquone also appears promising. Ribavirin has been recently shown to markedly improve survival in patients with Crimean-Congo hemorrhagic fever. The role of antiviral therapy in the treatment of other tick-borne viral infections, including other hemorrhagic fevers and tick-borne encephalitis, is not yet defined.
蜱虫可将细菌、原生动物和病毒感染传播给人类。其中几种感染有特定的治疗方法。对于所有年龄段患有落基山斑疹热、人单核细胞埃立克体病或人粒细胞埃立克体病的患者，多西环素是首选的抗菌治疗药物。氯霉素曾用于治疗儿童的这些感染，但明显不如多西环素。对于地中海斑疹热患者，多西环素、氯霉素和新型大环内酯类药物似乎都是有效的治疗方法。莱姆病的治疗取决于儿童的年龄和疾病阶段。对于早期局限性疾病，阿莫西林（适用于年龄<8岁者）或多西环素（适用于年龄≥8岁者）有效。多西环素、青霉素V（苯氧甲基青霉素）或青霉素G（苄青霉素）制剂以及红霉素都是蜱传回归热的有效治疗药物。住院的兔热病患者应接受庆大霉素或链霉素治疗。多西环素和环丙沙星已分别用于门诊兔热病的治疗研究；然而，这些药物在儿童该疾病治疗中的作用尚未确立。对于巴贝斯虫病患儿，首选克林霉素和奎宁联合治疗；阿奇霉素和阿托伐醌联合治疗似乎也有前景。最近已证明利巴韦林可显著提高克里米亚-刚果出血热患者的生存率。抗病毒治疗在其他蜱传病毒感染（包括其他出血热和蜱传脑炎）治疗中的作用尚未明确。
