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[皮肤病中的抗生素治疗]

[Antibiotic therapy in skin diseases].

作者信息

Owczarek Witold, Wydrzyńska Anna, Paluchowska Elwira

机构信息

Wojskowy Instytut Medyczny w Warszawie, Klinika Dermatologii CSK MON.

出版信息

Pol Merkur Lekarski. 2011 May;30(179):367-72.

Abstract

Antibiotics are used for systemic and topical skin diseases treatment, taking advantage of their antiseptic, bacteriostatic and also their anti-inflammatory and immunomodulating properties. In case of localized external skin layers infections, a topical treatment is adequate. In case of widespread and deeper infections a systemic treatment is needed. The latter dermatological diseases are mostly treated by beta-lactam antibiotics (penicillins and cefalosporins) macrolides and tetracycline. In topical treatment mostly erythromycin, clindamycin, mupirocyne and fusidic acid are used. Most common bacterial skin diseases, where topical treatment is sufficient are: impetigo contagiosa, folliculitis and erythrasma. Systemic treatment is required in case of: severe staphylococcal and streptococcal infections, sexually transmitted diseases, secondary bacterial infections (i.e. associated to severe AD or lower leg arterial and venous ulceration), acne vulgaris, rosacea and dermatosis with bacterial antigens pathogenesis influence (i.e. psoriasis, guttate parapsoriasis and angitis). Antibiotic resistance is one of the most worrying problems during the treatment; this is why a targeted therapy, with results guarantee, is mostly appropriate.

摘要

抗生素因其具有抗菌、抑菌、抗炎及免疫调节特性,被用于治疗全身性及局部性皮肤疾病。对于局部外层皮肤感染,局部治疗即可。对于广泛且较深层的感染,则需要进行全身治疗。后一类皮肤病大多采用β-内酰胺类抗生素(青霉素和头孢菌素)、大环内酯类抗生素及四环素进行治疗。局部治疗大多使用红霉素、克林霉素、莫匹罗星和夫西地酸。局部治疗就足够的最常见细菌性皮肤病有:脓疱疮、毛囊炎和红癣。在以下情况下需要进行全身治疗:严重的葡萄球菌和链球菌感染、性传播疾病、继发性细菌感染(即与重度特应性皮炎或小腿动静脉溃疡相关的感染)、寻常痤疮、玫瑰痤疮以及发病机制受细菌抗原影响的皮肤病(如银屑病、点滴状副银屑病和血管炎)。抗生素耐药性是治疗过程中最令人担忧的问题之一;这就是为什么大多采用有疗效保证的靶向治疗最为合适。

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