Konno Masatoshi, Baba Shunkichi, Mikawa Haruki, Hara Kohei, Matsumoto Fumio, Kaga Kimitaka, Nishimura Tadao, Kobayashi Toshimitsu, Furuya Nobuhiko, Moriyama Hiroshi, Okamoto Yoshitaka, Furukawa Mituru, Yamanaka Noboru, Matsushima Toshiharu, Yoshizawa Yasuyuki, Kohno Shigeru, Kobayashi Kunihiko, Morikawa Akihiro, Koizumi Shoichi, Sunakawa Keisuke, Inoue Matsuhisa, Ubukata Kimiko
Teikyo University School of Medicine, Tokyo, Japan.
J Infect Chemother. 2006 Oct;12(5):305-30. doi: 10.1007/s10156-006-0469-4. Epub 2006 Nov 6.
This report focuses on changes in the nasopharyngeal bacterial flora before and after administration of antimicrobial agents in 172 cases of acute upper respiratory infection in patients aged 6 years or younger. The antimicrobial agents administered were amoxicillin (AMPC) (34%), clavulanic acid/amoxicillin compound (11%), cefditren pivoxil (CDTR-PI) (43%), and others (12%). Changes in nasopharyngeal bacterial flora were investigated with reexaminations conducted after 2-5 days (day 2-5 subgroup), 6-10 days (day 6-10 subgroup), and 11 days and thereafter. There was a significant reduction in the Streptococcus pneumoniae detected in the group administered AMPC (AMPC group) in the day 2-5 subgroup and the day 6-10 subgroup. There was also a significant decrease in H. influenzae in the group administered CDTR-PI (CDTR-PI group) in the day 2-5 subgroup. From this it was inferred that for the most part significant changes in infectious nasopharyngeal bacteria occurred in the day 2-5 subgroups. However, a significant improvement in the degree of inflammation, as indicated by leukocyte infiltration images for the AMPC group, was observed in the day 2-5 subgroup, and for the CDTR-PI group in the day 6-10 subgroup. On the other hand, in both the antimicrobial agent groups, S. pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were newly detected at reexamination. Furthermore, a difference in the incidence of these bacteria was observed between the 2 antimicrobial agent groups. It was suggested that such phenomena related to the survival of resistant strains or a recurrence otitis media.
本报告聚焦于172例6岁及以下急性上呼吸道感染患者在使用抗菌药物前后鼻咽部细菌菌群的变化。所使用的抗菌药物为阿莫西林（AMPC）（34%）、克拉维酸/阿莫西林复方制剂（11%）、头孢地尼酯匹酯（CDTR-PI）（43%）以及其他（12%）。在用药后2 - 5天（第2 - 5天亚组）、6 - 10天（第6 - 10天亚组）以及11天及之后进行复查，以研究鼻咽部细菌菌群的变化。在第2 - 5天亚组和第6 - 10天亚组中，使用AMPC的组（AMPC组）检测到的肺炎链球菌显著减少。在第2 - 5天亚组中，使用CDTR-PI的组（CDTR-PI组）中的流感嗜血杆菌也显著减少。由此推断，感染性鼻咽部细菌的显著变化大多发生在第2 - 5天亚组。然而，在第2 - 5天亚组中观察到AMPC组的白细胞浸润图像显示炎症程度有显著改善，在第6 - 10天亚组中CDTR-PI组也有显著改善。另一方面，在两个抗菌药物组中，复查时均新检测到肺炎链球菌、流感嗜血杆菌和卡他莫拉菌。此外，在这两种抗菌药物组之间观察到这些细菌的发生率存在差异。提示这些现象与耐药菌株的存活或中耳炎复发有关。
