Friedland I R, McCracken G H
Department of Pediatrics, Baragwanath Hospital, Johannesburg, South Africa.
N Engl J Med. 1994 Aug 11;331(6):377-82. doi: 10.1056/NEJM199408113310607.
The increasing resistance of S. pneumoniae to antimicrobial agents is a cause for concern. Although a number of therapeutic strategies are possible, local patterns of resistance must be considered. It is essential to determine the susceptibility of individual strains to penicillin and other antimicrobial agents that could be used for therapy. Communication between the clinician and the laboratory is vital to determine the best therapeutic options. The recent recognition of cephalosporin-resistant strains emphasizes the need to determine susceptibility to cephalosporins. Clinical laboratories should be aware of the recently proposed changes in the definition of cephalosporin resistance, and clinicians need to be aware of how these changes affect the choice of antibiotic therapy. Until pneumococcal disease can be effectively prevented, we can expect resistant pneumococcal infections to continue to pose therapeutic difficulties.
肺炎链球菌对抗菌药物的耐药性不断增加令人担忧。尽管有多种治疗策略可行，但必须考虑局部耐药模式。确定各个菌株对青霉素和其他可用于治疗的抗菌药物的敏感性至关重要。临床医生与实验室之间的沟通对于确定最佳治疗方案至关重要。最近对头孢菌素耐药菌株的认识强调了确定对头孢菌素敏感性的必要性。临床实验室应了解最近提出的头孢菌素耐药性定义的变化，临床医生需要了解这些变化如何影响抗生素治疗的选择。在肺炎球菌疾病能够得到有效预防之前，我们可以预期耐药性肺炎球菌感染将继续带来治疗难题。
