Jerath Nameet, Shetty Ganesh
Pediatric Intensivist, Indraprastha Apollo Hospital, New Delhi, India.
Indian J Pediatr. 2007 Dec;74(12):1105-8. doi: 10.1007/s12098-007-0206-8.
Tonsillopharyngitis is very common in children, with Group A Streptococci being the most common bacterial etiology. Effective antibacterial treatment is imperative due to risk of rheumatic fever. Cephalosporins have been used successfully for the treatment of Group A beta-hemolytic Streptococcal (GABHS) tonsillopharyngitis. Cefprozil is a novel broad-spectrum oral cephalosporin. Cefprozil is rapidly absorbed from the gastrointestinal tract with high bioavailability. The excellent penetration of cefprozil into tonsillar and adenoidal tissue corresponds well with the clinical outcome. The drug provides excellent coverage against both gram-negative and -positive bacteria that may cause pharyngitis/tonsillitis. The beta-lactamase stability of cefprozil appears to exceed that of other oral cephalosporins for important gram negative pathogens. In clinical trials, cefprozil appears to be at least as effective as commonly used comparison agents such as cefaclor and cefixime. Additionally, cefprozil is better tolerated than the latter, especially with regard to gastrointestinal adverse effects. Thus cefprozil can be considered a safe and reliable drug for the treatment of Streptococcal tonsillopharyngitis in children.
扁桃体咽炎在儿童中非常常见，A组链球菌是最常见的细菌病因。由于存在风湿热风险，有效的抗菌治疗势在必行。头孢菌素已成功用于治疗A组β溶血性链球菌（GABHS）扁桃体咽炎。头孢丙烯是一种新型广谱口服头孢菌素。头孢丙烯从胃肠道迅速吸收，生物利用度高。头孢丙烯在扁桃体和腺样体组织中的良好渗透与临床结果相符。该药物对可能引起咽炎/扁桃体炎的革兰氏阴性菌和阳性菌均有良好的覆盖作用。对于重要的革兰氏阴性病原体，头孢丙烯的β-内酰胺酶稳定性似乎超过其他口服头孢菌素。在临床试验中，头孢丙烯似乎至少与常用对照药物如头孢克洛和头孢克肟一样有效。此外，头孢丙烯的耐受性优于后者，尤其是在胃肠道不良反应方面。因此，头孢丙烯可被认为是治疗儿童链球菌性扁桃体咽炎的一种安全可靠的药物。
