Raff M J
Postgrad Med J. 1983;59 Suppl 5:32-9.
Cephalexin has had 12 years of extensive clinical usage in the management of respiratory tract and other infections. It is reliably absorbed from the gastrointestinal tract and reaches therapeutic levels in serum and tissues. Toxicity and adverse side effects are minimal. The antimicrobial spectrum includes a majority of the pathogens usually associated with community-acquired lower respiratory tract infections with the significant exception of Haemophilus influenzae. Resistance of H. influenzae strains reduces the uses of cephalexin in the paediatric population and may limit its effectiveness in some patients with acute exacerbations of chronic bronchitis. In contrast, it is inordinately effective in managing most adult patients with lower respiratory tract infections, either as a primary agent, as a substitute for penicillins or other antimicrobial agents in patients unable to receive these, or for continuation of therapy in individuals who no longer require parenteral compounds. As with other cephalosporins, caution should be exercised to exclude meningitis when treating patients with respiratory tract infections since the majority of these compounds, including cephalexin, produce little or no cerebrospinal fluid levels.
头孢氨苄在呼吸道及其他感染的治疗中已有12年的广泛临床应用历史。它能从胃肠道可靠吸收,并在血清和组织中达到治疗水平。毒性和副作用极小。抗菌谱包括大多数通常与社区获得性下呼吸道感染相关的病原体,但流感嗜血杆菌是个显著例外。流感嗜血杆菌菌株的耐药性降低了头孢氨苄在儿科人群中的使用,并可能限制其在一些慢性支气管炎急性加重患者中的疗效。相比之下,它在治疗大多数患有下呼吸道感染的成年患者时极为有效,既可以作为主要药物,也可以作为无法使用青霉素或其他抗菌药物的患者的替代药物,或者用于不再需要胃肠外给药的患者继续治疗。与其他头孢菌素一样,在治疗呼吸道感染患者时应谨慎排除脑膜炎,因为包括头孢氨苄在内的大多数此类化合物在脑脊液中的浓度很低或几乎没有。