Ball P
Infectious Diseases Unit, Cameron Hospital, Windygates, Fife, UK.
J Antimicrob Chemother. 1991 Dec;28 Suppl C:121-30. doi: 10.1093/jac/28.suppl_c.121.
The use of new quinolones has become established therapy for many community infections including urinary tract infection, genital infection, soft tissue infection and some forms of lower respiratory tract infection. However, there has been an undercurrent of anxiety concerning their efficacy in pneumococcal infections. Temafloxacin has improved activity against pneumococci and its high oral bioavailability and excellent penetration into respiratory tissues now combine to provide a suitable profile for the management of a wider range of respiratory infections. Eradication rates in acute exacerbations of chronic bronchitis collated from individual studies are 98% overall and 100% in pneumococcal infections. Furthermore, eradication rates in smokers and the elderly illustrate significant advantages for temafloxacin when compared with previous quinolones. In pneumonia, a twice-daily temafloxacin regimen has given equivalent overall results to those of amoxycillin (84.6% vs 80%). In proven pneumococcal pneumonia, equivalent results (78.6% vs 78.4%) have been obtained with both drugs. A daily 600 mg dose of temafloxacin eradicated 94% of pneumococcal isolates in one study and in another this agent given twice-daily orally proved comparable to parenteral cephalosporin treatment. Temafloxacin shares with other quinolones excellent bacteriological and clinical efficacy against Haemophilus influenzae and Moraxella catarrhalis. These results and the lack of potential interaction with theophylline indicate temafloxacin to be suitable for domiciliary management of respiratory tract infections in addition to a broad range of other community infectious diseases.
新型喹诺酮类药物已成为许多社区感染的既定治疗药物,包括尿路感染、生殖器感染、软组织感染以及某些形式的下呼吸道感染。然而,人们一直对其在肺炎球菌感染中的疗效存在潜在担忧。替马沙星对肺炎球菌的活性有所提高,其高口服生物利用度以及对呼吸道组织的出色渗透能力,现在结合起来为管理更广泛的呼吸道感染提供了合适的特性。从个别研究汇总的慢性支气管炎急性加重期的根除率总体为98%,肺炎球菌感染的根除率为100%。此外,与先前的喹诺酮类药物相比,替马沙星在吸烟者和老年人中的根除率显示出显著优势。在肺炎方面,替马沙星每日两次给药方案的总体结果与阿莫西林相当(84.6%对80%)。在确诊的肺炎球菌肺炎中,两种药物的结果相当(78.6%对78.4%)。在一项研究中,每日600毫克剂量的替马沙星根除了94%的肺炎球菌分离株,在另一项研究中,这种药物每日两次口服被证明与胃肠外头孢菌素治疗相当。替马沙星与其他喹诺酮类药物一样,对流感嗜血杆菌和卡他莫拉菌具有出色的细菌学和临床疗效。这些结果以及与茶碱缺乏潜在相互作用表明,替马沙星除了适用于广泛的其他社区传染病外,还适用于呼吸道感染的家庭治疗。