Wilson A P, Grüneberg R N
Department of Clinical Microbiology, University College Hospital, London, UK.
Eur J Clin Microbiol Infect Dis. 1994 Sep;13(9):701-10. doi: 10.1007/BF02276052.
Administration of parenteral antibiotics to outpatients is increasingly used to reduce hospital costs, to reduce loss of earnings for the patient and to improve the quality of life in patients requiring prolonged antibiotic treatment. The glycopeptides are required for treatment of infections caused by methicillin resistant staphylococci and some enterococci, or for treatment of patients allergic to beta-lactam agents. For home therapy, teicoplanin has some advantages over vancomycin in that it requires only once-daily bolus administration, does not necessitate monitoring of serum concentrations and offers the choice of intravenous or intramuscular administration. Teicoplanin has been used to complete treatment of endocarditis at home in selected patients, streptococcal disease being the most suitable form of endocarditis for this treatment. In open trials, teicoplanin has been found effective in home therapy of osteomyelitis but, as with other agents, prolonged dosage can be associated with adverse effects. It has also been used for home treatment of infections of the respiratory tract, intravascular catheters and soft tissue. Despite its higher acquisition costs, teicoplanin is to be preferred over vancomycin because of the reduced administration and assay costs and fewer adverse effects.
门诊患者使用胃肠外抗生素越来越多地用于降低医院成本、减少患者收入损失以及提高需要长期抗生素治疗患者的生活质量。糖肽类药物用于治疗耐甲氧西林葡萄球菌和某些肠球菌引起的感染，或用于治疗对β-内酰胺类药物过敏的患者。对于家庭治疗，替考拉宁比万古霉素有一些优势，因为它只需每日一次大剂量给药，无需监测血清浓度，并且提供静脉或肌肉注射的选择。替考拉宁已用于在选定患者家中完成心内膜炎的治疗，链球菌病是最适合这种治疗的心内膜炎形式。在开放试验中，已发现替考拉宁在家中治疗骨髓炎有效，但与其他药物一样，长期用药可能会有不良反应。它也已用于呼吸道、血管内导管和软组织感染的家庭治疗。尽管其购置成本较高，但由于给药和检测成本降低以及不良反应较少，替考拉宁比万古霉素更可取。
