门诊环境下下呼吸道感染的管理：聚焦于克拉霉素
Management of lower respiratory tract infection in outpatient settings: Focus on clarithromycin.
作者信息
Mahashur Ashok
机构信息
P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
出版信息
Lung India. 2018 Mar-Apr;35(2):143-149. doi: 10.4103/lungindia.lungindia_262_17.
Abstract
Lower respiratory tract infection (LRTI) is a broad terminology which includes acute bronchitis, pneumonia, acute exacerbations of chronic obstructive pulmonary disease/chronic bronchitis (AECB), and acute exacerbation of bronchiectasis. Acute LRTIs (ALRTIs) are one of the common clinical problems in community and hospital settings. Management of community-acquired pneumonia (CAP) and AECB may pose challenges because of diagnostic difficulty in differentiating infections caused by typical and atypical microorganisms and rising rates of antimicrobial resistance. Beta-lactam antibiotics, macrolides, and fluoroquinolones are routinely prescribed medicines for the management of ALRTIs. Macrolides are time-tested and effective agents for the treatment of LRTIs. Clarithromycin, a macrolide, offers several benefits in the management of ALRTIs. In this article, we discuss the management approach of LRTIs with focus on clarithromycin in the management of mild-to-moderate LRTIs (CAP and AECB), i.e., in outpatient settings.
摘要
下呼吸道感染（LRTI）是一个宽泛的术语，包括急性支气管炎、肺炎、慢性阻塞性肺疾病/慢性支气管炎急性加重（AECB）以及支气管扩张症急性加重。急性下呼吸道感染（ALRTIs）是社区和医院环境中常见的临床问题之一。由于在鉴别由典型和非典型微生物引起的感染方面存在诊断困难以及抗菌药物耐药率不断上升，社区获得性肺炎（CAP）和AECB的管理可能会带来挑战。β-内酰胺类抗生素、大环内酯类抗生素和氟喹诺酮类药物是治疗急性下呼吸道感染的常用处方药。大环内酯类抗生素是久经考验且有效的下呼吸道感染治疗药物。克拉霉素作为一种大环内酯类抗生素，在急性下呼吸道感染的管理中具有多种益处。在本文中，我们将讨论下呼吸道感染的管理方法，重点是克拉霉素在轻度至中度下呼吸道感染（CAP和AECB）管理中的应用，即在门诊环境中的应用。
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