Toomey K E, Barnes R C
Division of STD/HIV Prevention, Centers for Disease Control, Atlanta, Georgia 30333.
Rev Infect Dis. 1990 Jul-Aug;12 Suppl 6:S645-55. doi: 10.1093/clinids/12.supplement_6.s645.
Chlamydia trachomatis infections are the most frequent bacterial sexually transmitted diseases in the United States, with an estimated 4 million cases occurring annually. The mainstay of treatment for chlamydial infections has been the tetracyclines. Doxycycline, comparable in cost to tetracycline and with a less frequent dosage schedule, is the drug of first choice. Erythromycins are the drugs of choice for infections in pregnant women, nursing mothers, infants, children, and adults unable to tolerate tetracyclines. beta-Lactam antibiotics have had variable efficacy against C. trachomatis infections, although recent studies suggest that amoxicillin may be an effective alternative for C. trachomatis infection during pregnancy. Quinolones are currently being tested and may be used in alternative regimens in the future. The effectiveness of current antimicrobial regimens in preventing long-term complications of chlamydial infections should be determined in research studies.
沙眼衣原体感染是美国最常见的细菌性性传播疾病,估计每年有400万例。衣原体感染的主要治疗药物一直是四环素类。多西环素成本与四环素相当,给药频率较低,是首选药物。红霉素是孕妇、哺乳期妇女、婴儿、儿童以及无法耐受四环素的成年人感染的首选药物。β-内酰胺类抗生素对沙眼衣原体感染的疗效不一,不过最近的研究表明阿莫西林可能是孕期沙眼衣原体感染的有效替代药物。喹诺酮类药物目前正在进行试验,未来可能用于替代治疗方案。目前抗菌治疗方案在预防衣原体感染长期并发症方面的有效性应通过研究来确定。