Patrick C C
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Pediatr Infect Dis J. 1997 Jan;16(1):135-9; discussion 160-2. doi: 10.1097/00006454-199701000-00038.
The use of fluorinated quinolone antibiotics to selectively decontaminate the gastrointestinal tract is a reasonable alternative to prevent infection in neutropenic patients. The fluoroquinolones represent ideal antibiotics with which to achieve the principles of selective decontamination by allowing colonization of anaerobes to inhibit the adherence, colonization and proliferation of potentially pathogenic aerobic flora.
This report describes the prophylactic use of fluoroquinolones in neutropenic patients.
The majority of studies of fluoroquinolone prophylaxis in neutropenic patients have shown a reduction in documented Gram-negative bacterial infections. However, Gram-positive infections, particularly those with viridans streptococci, present a major impediment to the use of single agent prophylaxis with a quinolone.
Prophylaxis with fluoroquinolones in neutropenic patients was found to be advantageous, but it must be balanced against the risk of Gram-positive infections and the potential for antibiotic resistance.
使用氟喹诺酮类抗生素对胃肠道进行选择性去污是预防中性粒细胞减少患者感染的一种合理替代方法。氟喹诺酮类药物是理想的抗生素,通过允许厌氧菌定植来抑制潜在致病性需氧菌的黏附、定植和增殖,从而实现选择性去污的原则。
本报告描述了氟喹诺酮类药物在中性粒细胞减少患者中的预防性应用。
大多数关于氟喹诺酮类药物在中性粒细胞减少患者中预防性应用的研究表明,有记录的革兰氏阴性菌感染有所减少。然而,革兰氏阳性菌感染,尤其是草绿色链球菌感染,是使用喹诺酮类单药预防的主要障碍。
在中性粒细胞减少患者中使用氟喹诺酮类药物进行预防被发现是有益的,但必须权衡革兰氏阳性菌感染的风险和抗生素耐药性的可能性。