Asperilla M O, Smego R A, Scott L K
Department of Medicine, Albany Medical College, New York.
Rev Infect Dis. 1990 Sep-Oct;12(5):873-89. doi: 10.1093/clinids/12.5.873.
The 4-fluoroquinolones are a new class of antimicrobial agents that possess broad in vitro antibacterial activity, including efficacy against enteric pathogens such as Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio species. These drugs are clinically effective against both drug-sensitive and multiresistant strains of Salmonella typhi and Salmonella paratyphi that cause enteric fever. In salmonella enterocolitis, the quinolones--unlike older antimicrobial agents that may have little impact on the duration of symptomatic illness and can in fact prolong fecal carriage of salmonellae--actually shorten the course of clinical disease and terminate excretion of these organisms in the stool. Similarly, for chronic carriers of both typhoidal and nontyphoidal Salmonella strains, the quinolones are effective in eradicating biliary and fecal reservoirs of infection. Immunosuppressed persons with salmonellosis, such as those with AIDS, may benefit from both short-term treatment and prolonged prophylaxis with a quinolone antibiotic. The optimal agent, dose, and duration of quinolone therapy for all salmonella syndromes remain to be determined by larger controlled trials.
4-氟喹诺酮类是一类新型抗菌药物，具有广泛的体外抗菌活性，包括对肠道病原体如沙门氏菌、志贺氏菌、弯曲杆菌、耶尔森氏菌和弧菌属的抗菌效果。这些药物对引起肠热症的伤寒沙门氏菌和副伤寒沙门氏菌的药敏菌株和多重耐药菌株在临床上均有效。在沙门氏菌小肠结肠炎中，与那些可能对症状性疾病持续时间影响不大且实际上可能延长沙门氏菌粪便携带时间的较老抗菌药物不同，喹诺酮类药物实际上缩短了临床疾病病程并终止了这些病原体在粪便中的排泄。同样，对于伤寒和非伤寒沙门氏菌菌株的慢性携带者，喹诺酮类药物可有效根除感染的胆汁和粪便储存库。患有沙门氏菌病的免疫抑制人群，如艾滋病患者，可能从喹诺酮类抗生素的短期治疗和长期预防中获益。对于所有沙门氏菌综合征，喹诺酮类治疗的最佳药物、剂量和疗程仍有待更大规模的对照试验来确定。
