Gendrel D, Cohen R
Université et Faculté de médecine PARIS 5, Hôpital Saint-Vincent de Paul-Cochin, 74 Av Denfert-Rochereau, 75014 Paris, France.
Arch Pediatr. 2008 Oct;15 Suppl 2:S93-6. doi: 10.1016/S0929-693X(08)74223-4.
The need to limit unnecessary antibiotic treatments and recent studies with unusual antibiotics in pediatrics (fluoroquinolones) or in digestive tract infections (azithromycin) have led to update the treatment of acute gastro-enteritis. In 2007, the European Society for Pediatric Infectious Diseases and the European Society for Gastroenterology Hepatology and Nutrition have issued guidelines. The proven shigellosis as well as the strong suspicion have to be treated promptly with antibiotics, mainly azithromycin. There is no argument to treat moderate salmonella gastroenteritis or carriage. However, the severe cases and those occurring in high risk patient must be treated (ciprofloxacin or ceftriaxone). It is recommended to treat diarrhoea due to Campylobacter jejuni in case of early diagnosis. The presumptive antibiotic treatment should be limited but can not be dismissed, in invasive cases gastro-enteritis, especially in traveller children.
限制不必要的抗生素治疗的必要性以及近期在儿科(氟喹诺酮类)或消化道感染(阿奇霉素)中使用特殊抗生素的研究促使急性胃肠炎的治疗方法得到更新。2007年,欧洲儿科传染病学会和欧洲胃肠病学、肝脏病学和营养学会发布了指南。确诊的志贺菌病以及高度疑似病例必须迅速使用抗生素治疗,主要是阿奇霉素。对于中度沙门氏菌胃肠炎或带菌状态,无需进行治疗。然而,严重病例以及高危患者发生的病例必须进行治疗(环丙沙星或头孢曲松)。对于早期诊断的空肠弯曲菌所致腹泻,建议进行治疗。在侵袭性胃肠炎病例中,尤其是在旅行儿童中,推定的抗生素治疗应受到限制,但不能排除。