Kwong Christina G, Bacharier Leonard B
Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis Children's Hospital, One Children's Place, St. Louis, MO, 63110, USA.
Curr Allergy Asthma Rep. 2017 May;17(5):34. doi: 10.1007/s11882-017-0701-6.
Antibiotics are commonly used to treat wheezy lower respiratory tract illnesses in preschoolers, although these infections have been traditionally thought to be predominantly of viral origin. Our purpose is to review recent research pertaining to the role of antibiotics in lower respiratory tract illnesses and on subsequent asthma development, as well as the possible mechanisms of their effects.
Increasing evidence suggests that asthma pathogenesis is associated with events during infancy and early childhood, particularly respiratory tract infections. While viruses are frequently detected in children with lower respiratory tract infections, the presence of potentially pathogenic bacteria is also often detected and may play a role in asthma pathogenesis. Recent evidence suggests that use of macrolides, particularly azithromycin, may decrease the risk of and duration of lower respiratory tract illnesses and prevent future episodes in specific high-risk populations. Infants and preschoolers who have wheezy lower respiratory tract illnesses have a higher risk of asthma development. Alterations in the microbiome are thought to be influential. While several recent studies identify azithromycin as a therapeutic option in these illnesses, additional research is needed.
抗生素常用于治疗学龄前儿童喘息性下呼吸道疾病，尽管传统上认为这些感染主要由病毒引起。我们的目的是综述近期有关抗生素在下呼吸道疾病中的作用及其对后续哮喘发展的影响的研究，以及其作用的可能机制。
越来越多的证据表明，哮喘发病机制与婴儿期和幼儿期的事件有关，尤其是呼吸道感染。虽然在下呼吸道感染儿童中经常检测到病毒，但也经常检测到潜在致病菌的存在，并且可能在哮喘发病机制中起作用。最近的证据表明，使用大环内酯类药物，尤其是阿奇霉素，可能会降低下呼吸道疾病的风险和持续时间，并预防特定高危人群未来的发作。患有喘息性下呼吸道疾病的婴儿和学龄前儿童患哮喘的风险更高。微生物群的改变被认为具有影响作用。虽然最近的几项研究将阿奇霉素确定为这些疾病的一种治疗选择，但仍需要更多的研究。
