Spencer R C
Bristol Public Health Laboratory, Bristol Royal Infirmary, UK.
J Antimicrob Chemother. 1998 May;41 Suppl C:21-7. doi: 10.1093/jac/41.suppl_3.21.
High Clostridium difficile disease rates were originally associated with clindamycin use, but this association has declined in recent years following the decline in the clinical use of clindamycin, and disease is now particularly associated with the use of broad-spectrum antibiotics, especially the cephalosporins. There are now sufficient reports in the literature to merit the discontinuation of the widespread use of cephalosporins, especially in the elderly, by the substitution, wherever possible, with antibiotics not associated with the promotion of C. difficile-associated disease. Such agents include benzylpenicillin, gentamicin, trimethoprim, ciprofloxacin and the ureido-penicillins. Widespread education about the proper use of antibiotics in clinical practice remains essential.
艰难梭菌疾病的高发病率最初与克林霉素的使用有关，但近年来随着克林霉素临床使用量的下降，这种关联已减弱，目前该疾病尤其与广谱抗生素的使用有关，特别是头孢菌素类。现在文献中有足够的报道表明，应停止广泛使用头孢菌素，尤其是在老年人中，尽可能用与艰难梭菌相关疾病发生无关的抗生素替代。这类药物包括苄青霉素、庆大霉素、甲氧苄啶、环丙沙星和脲基青霉素。在临床实践中广泛开展关于正确使用抗生素的教育仍然至关重要。
