Smith J A
Division of Medical Microbiology, Vancouver General Hospital, British Columbia, Canada.
Eur J Clin Microbiol Infect Dis. 1991 Apr;10(4):330-3. doi: 10.1007/BF01967007.
Intra-abdominal sepsis may be caused by intestinal bacteria or by skin bacteria. In the largest series of patients studied in trials of quinolones, anti-anaerobic drugs were included in the therapeutic regimen. Several small series have reported success without the concomitant use of anti-anaerobic drugs. The balance of evidence at present suggests that the quinolones referred to in this report should be supplemented with anti-anaerobic drugs in the treatment of peritonitis related to bowel disease. Quinolones alone have been highly effective in the treatment of peritonitis associated with chronic ambulatory peritoneal dialysis, spontaneous bacterial peritonitis and biliary sepsis. Notwithstanding this success, the potential for an anaerobic aetiology in biliary sepsis and bacteremia must be borne in mind. Lack of clinical efficacy may be associated with resistant bacteria including streptococci. Quinolones offer a relatively non-toxic alternative in the management of intra-abdominal sepsis as well as being cost-saving since early discharge from hospital on oral medication is possible.
腹腔内感染可能由肠道细菌或皮肤细菌引起。在喹诺酮类药物试验中所研究的最大规模患者系列中，治疗方案中包含了抗厌氧菌药物。有几个小规模系列报道称在未同时使用抗厌氧菌药物的情况下也取得了成功。目前的证据平衡表明，在治疗与肠道疾病相关的腹膜炎时，本报告中提及的喹诺酮类药物应补充抗厌氧菌药物。喹诺酮类药物单独使用在治疗与慢性非卧床腹膜透析、自发性细菌性腹膜炎和胆源性败血症相关的腹膜炎方面一直非常有效。尽管取得了这一成功，但必须牢记胆源性败血症和菌血症中存在厌氧病因的可能性。临床疗效不佳可能与包括链球菌在内的耐药菌有关。喹诺酮类药物在腹腔内感染的治疗中提供了一种相对无毒的替代方案，而且由于口服药物后可早期出院，还节省了费用。
