Ball P
Infectious Diseases Unit, Cameron Hospital, Fife, Scotland, U.K.
Rev Infect Dis. 1989 Jul-Aug;11 Suppl 5:S1365-70. doi: 10.1093/clinids/11.supplement_5.s1365.
Although short courses of 4-quinolones are effective in routine infections, longer courses are necessary for chronic, deep-seated sepsis. Oral 4-quinolones exhibit efficacy equal to that of traditional parenteral regimens against osteomyelitis caused by gram-negative pathogens and have proved successful against chronic prostatitis and suppurative otorhinologic infections. The efficacy of these agents in the prophylaxis of urinary tract infection, travelers' diarrhea, and infections in neutropenic patients suggests other indications for potential widespread, long-term use. It is therefore important that the tolerability of regimens extending from 3-6 weeks to greater than or equal to 12 months has proved excellent. Potentially serious adverse reactions (including arthritis, cataract formation, and mutagenesis) noted in chronic animal toxicity or in vitro studies have no apparent human counterparts. However, experience is limited, and restrictions on use of the quinolones in children--except where real benefit outweighs theoretical risk--should not yet be abandoned.
虽然短期使用4-喹诺酮类药物对常规感染有效，但对于慢性、深部脓毒症则需要更长疗程。口服4-喹诺酮类药物对革兰氏阴性病原体引起的骨髓炎，其疗效与传统胃肠外给药方案相当，且已证明对慢性前列腺炎和化脓性耳鼻喉感染有效。这些药物在预防尿路感染、旅行者腹泻以及中性粒细胞减少患者感染方面的疗效提示了其潜在广泛、长期使用的其他适应证。因此，重要的是，已证明疗程从3至6周延长至大于或等于12个月的耐受性极佳。在慢性动物毒性或体外研究中发现的潜在严重不良反应（包括关节炎、白内障形成和诱变）在人类中没有明显对应情况。然而，经验有限，除了实际益处超过理论风险的情况外，目前不应放弃对儿童使用喹诺酮类药物的限制。
