Gupta Ravindra K, George Robert, Nguyen-Van-Tam Jonathan S
Department of Infectious Diseases, John Radcliffe Hospital, Oxford, UK.
Emerg Infect Dis. 2008 Aug;14(8):1187-92. doi: 10.3201/eid1408.070751.
Pandemic influenza planning is well under way across the globe. Antiviral drugs and vaccines have dominated the therapeutic agenda. Far less work has been conducted on stockpiling and planning for deployment of antimicrobial drugs against secondary bacterial pneumonia, a cause of substantial illness and death in previous pandemics and epidemics. In the event of a pandemic, effective antimicrobial drug measures are expected to substantially benefit public health. We address issues regarding use of antimicrobial drugs as stocks of individual agents are diminished and the role of resistance surveillance in informing such policy. Furthermore, vaccination with polysaccharide and conjugate pneumococcal vaccines is considered as part of a pandemic strategy. Most illness and death from influenza are likely to occur in developing countries, where neuraminidase inhibitors and vaccines may be neither affordable nor available; thus, compared with industrialized countries, the benefits of treating bacterial complications in developing countries may be substantially greater.
全球范围内针对大流行性流感的规划正在紧锣密鼓地进行。抗病毒药物和疫苗一直是治疗议程的重点。而针对继发性细菌性肺炎储备和部署抗菌药物的相关工作开展得要少得多，继发性细菌性肺炎是在以往大流行和疫情中导致大量发病和死亡的一个原因。一旦发生大流行，有效的抗菌药物措施预计将极大地有益于公众健康。随着个别药物储备的减少，我们探讨了抗菌药物使用方面的问题以及耐药性监测在为这类政策提供信息方面的作用。此外，多糖和结合型肺炎球菌疫苗接种被视为大流行战略的一部分。大多数流感导致的发病和死亡可能发生在发展中国家，在这些国家，神经氨酸酶抑制剂和疫苗可能既买不起也无法获得；因此，与工业化国家相比，在发展中国家治疗细菌并发症的益处可能要大得多。
