Gadomski A M
Department of Pediatrics, University of Maryland, Baltimore.
Pediatr Infect Dis J. 1993 Feb;12(2):115-20. doi: 10.1097/00006454-199302000-00002.
Upper respiratory infections (URI) are a source of significant morbidity in childhood and have been associated with the development of certain bacterial infections. However, the high incidence of URI contrasted with the low incidence of lower respiratory infection (LRI) suggests a low rate of development of viral or bacterial LRI after URI. Because the etiology of URI is primarily viral, antibiotics do not have any significant effect on the URI episode itself but have been used to treat URI in hopes of preventing bacterial complications after URI. Meta-analysis of studies in developed and developing settings suggests that antibiotic treatment of children with URI does not shorten the course of URI and does not prevent the development of pneumonia. Several studies reporting both positive and negative results could not be included in the meta-analysis because they were not randomized trials or did not detail LRI outcomes in children sufficiently. Because of limitations in study design and definition of LRI, research in this area cannot be considered definitive. However, the weight of theoretical and experimental evidence is against antibiotic treatment of URI as a means of preventing the development of pneumonia after URI.
上呼吸道感染（URI）是儿童发病的一个重要原因，并且与某些细菌感染的发生有关。然而，URI的高发病率与下呼吸道感染（LRI）的低发病率形成对比，这表明URI后病毒或细菌性LRI的发生率较低。由于URI的病因主要是病毒，抗生素对URI发作本身没有任何显著影响，但已被用于治疗URI，以期预防URI后的细菌并发症。对发达国家和发展中国家研究的荟萃分析表明，用抗生素治疗URI患儿并不能缩短URI病程，也不能预防肺炎的发生。一些报告了阳性和阴性结果的研究未被纳入荟萃分析，因为它们不是随机试验，或者没有充分详细地说明儿童的LRI结果。由于研究设计和LRI定义的局限性，该领域的研究不能被视为定论。然而，理论和实验证据的权重反对将抗生素治疗URI作为预防URI后肺炎发生的一种手段。
