Brown Lauren April, Mitchell Andrea M, Mitchell Tim J
iBMedSci, The University of Birmingham, Birmingham, UK.
Pneumococcal Research Group, Institute of Microbiology and Infection, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK.
J Med Microbiol. 2017 Aug;66(8):1253-1256. doi: 10.1099/jmm.0.000545.
(), otherwise known as 'the pneumococcus', is a fascinating microbe that continues to pose a significant problem to public health. Currently there are no specific National Institute for Clinical Excellence (NICE) or British Thoracic Society (BTS) clinical guidelines referring to the treatment of invasive pneumococcal infection. NICE clinical guidelines suggest the use of lytic β-lactam antibiotic regimens for the management of community-acquired pneumonia and bacterial meningitis; infections for which is a likely causative organism. Lytic antibiotics have been shown to increase the release of pneumolysin (the highly inflammatory and damaging toxin of the pneumococcus), thus theoretically increasing host damage, which may lead to a decline of clinical outcomes in vulnerable patients. In light of this information, should the use of non-lytic antibiotics, such as quinolones, rifamycins and macrolides, be considered for the treatment of invasive pneumococcal disease?
（），又称“肺炎球菌”，是一种引人入胜的微生物，它继续给公共卫生带来重大问题。目前，英国国家临床优化研究所（NICE）或英国胸科学会（BTS）没有关于侵袭性肺炎球菌感染治疗的具体临床指南。NICE临床指南建议使用溶菌性β-内酰胺抗生素方案来管理社区获得性肺炎和细菌性脑膜炎；肺炎球菌很可能是这些感染的病原体。已证明溶菌性抗生素会增加肺炎溶血素（肺炎球菌具有高度炎症性和破坏性的毒素）的释放，因此从理论上讲会增加宿主损伤，这可能导致脆弱患者的临床结局下降。鉴于此信息，对于侵袭性肺炎球菌疾病的治疗，是否应考虑使用非溶菌性抗生素，如喹诺酮类、利福霉素类和大环内酯类？
