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社区获得性肺炎管理的临床经验:氟喹诺酮类药物使用的经验教训

Clinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolones.

作者信息

Carratalá J, Martín-Herrero J E, Mykietiuk A, García-Rey C

机构信息

Infectious Disease Service, IDIBELL, Hospital Universitari de Bellvitge, Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Clin Microbiol Infect. 2006 May;12 Suppl 3:2-11. doi: 10.1111/j.1469-0691.2006.01392.x.

Abstract

Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide. The treatment of CAP has been complicated by several factors, including the expanding spectrum of causative organisms and the rising prevalence of antibiotic resistance among respiratory pathogens. Initial antimicrobial treatment for patients with CAP is usually selected empirically and should provide appropriate coverage against the most common causative organisms, including resistant strains. Respiratory fluoroquinolones, such as levofloxacin, are the only antimicrobials that are highly active against the pathogens most frequently implicated in CAP, including macrolide-resistant and penicillin-resistant pneumococci, Haemophilus influenzae, Legionella spp., and atypical agents. This paper reviews recent studies involving adult patients with CAP that suggest that levofloxacin, as compared with other conventional antibiotic treatments, may be associated with better clinical outcomes.

摘要

社区获得性肺炎(CAP)仍然是全球发病和死亡的主要原因。CAP的治疗因多种因素而变得复杂,包括致病微生物谱的扩大以及呼吸道病原体中抗生素耐药性的日益普遍。CAP患者的初始抗菌治疗通常是经验性选择,应能针对最常见的致病微生物提供适当的覆盖,包括耐药菌株。呼吸喹诺酮类药物,如左氧氟沙星,是唯一对CAP中最常涉及的病原体具有高活性的抗菌药物,包括耐大环内酯类和耐青霉素的肺炎球菌、流感嗜血杆菌、军团菌属以及非典型病原体。本文综述了近期涉及成年CAP患者的研究,这些研究表明,与其他传统抗生素治疗相比,左氧氟沙星可能带来更好的临床结果。

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