Pereira P Ricardo, Borges Fernando, Mansinho Kamal
Serviço de Medicina Interna, Hospital Pedro Hispano, Matosinhos, Portugal.
Acta Med Port. 2013 Jan-Feb;26(1):43-50. Epub 2013 Apr 24.
The duration of antibiotic therapy in bacterial meningitis is a controversial issue. Antibiotic regimens have changed over time along with the criteria used to determine the ideal antibiotic therapy duration. The authors aim to make an historical overview on this matter and simultaneously add the evidence of recent studies, pointing out some issues in results interpretation, namely, their design and the associated demographic and epidemiological questions. Clinical assays on this subject, with statistically significant results, are quite recent. Most of the scientific knowledge has been acquired empirically through the times. The actual investigation paradigm, in what concerns to antibiotic therapy in bacterial meningitis, lays on the dichotomy: "short versus long duration regimens". Nevertheless, so far, the existing studies have not completely cleared this doubt. Thus, despite some evidence suggests that short duration antibiotic regimens are effective for some patients, in patients with severe disease presentations or with other morbidities its use may be questioned.
细菌性脑膜炎抗生素治疗的持续时间是一个有争议的问题。随着用于确定理想抗生素治疗持续时间的标准的变化,抗生素治疗方案也随时间发生了改变。作者旨在对此问题进行历史概述,同时补充近期研究的证据,指出结果解读中的一些问题,即研究设计以及相关的人口统计学和流行病学问题。关于这一主题的具有统计学显著结果的临床检测是相当近期才出现的。大部分科学知识是随着时间通过经验积累获得的。在细菌性脑膜炎抗生素治疗方面,实际的研究范式存在“短疗程与长疗程方案”的二分法。然而,到目前为止,现有研究尚未完全消除这一疑问。因此,尽管有一些证据表明短疗程抗生素方案对某些患者有效,但对于病情严重或有其他疾病的患者,其使用可能会受到质疑。