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抗呼吸道感染药物耐药和抗菌活性的现状 |
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李性天
摘 要 目的： 了解抗呼吸道感染药物的耐药现状及治疗 对策。 方法： 回顾1997年以来有关呼吸道感染致病菌的流行病学调查及抗 菌药物活性分析文献。 结果： 上呼吸道感染和下呼吸道感染(社区获得性) 的主要病原体如肺炎链球菌等对青霉素、 氨苄西林、 四环素、 大环内酯类和第1代头孢类 的耐药已趋严重， 新上市的喹诺酮类如曲伐沙星等对绝大多数肺炎链球菌具良好的抗菌活 性； 自70年代出现可产生β-内酰胺酶的流感杆菌， 但其对头孢类和非β-内酰胺类抗生 素的耐药性少见； 99%以上的卡他性嗜血杆菌对除青霉素、 氨苄西林外的β-内酰胺类药 物敏感， 对新上市的大环内酯类和喹诺酮类100%敏感。 口服头孢类对肺炎支原体等非典型 病原体基本无作用， 但喹诺酮类和大环内酯类新品种对其疗效极佳。 可静脉注射的链阳菌 素类quinupristin-dalfopristin对甲氧西林敏感或耐药的金葡菌、 肺炎链球菌均具明显 活性。结论： 应重视细菌的耐药性问题， 加强有关流行病学调查和分析。
关键词 抗菌药物 耐药性 抗菌活性 呼吸道感染 综述
The Current Status of Drug-Resistance and Antibiotic Activity of Antibiotics for Infection of Respiratory Tract
Li Xingtian
(Laboratory of Clinical Pharmacology, Wuhan Railway Central Hospital, Wuhan 430064, P.R.China)
ABSTRACT To get information on the current status of drug resistance of antibiotics for respiratory tract infection, the literature were collected on epidmiological studies of pathogenic bacteria of respiratory tract infections and analysis of antibiotic activity of antibiotics. The drug-resisance of main pathogens of upper and lower respiratory tract infection (community-acquired pneumonia), such as streptococus pneumoniae, to penicillin, ampicillin, tetracyclin, macrolides, and first generation cephalosporins, are getting serious. The newly-launched quinolones such as trovafloxacin, possess very good antibiotic activity on most streptococcus pneumoniae. Since 1970s, a kind of Bacillus Influenzae developed which can produce β-lactamase but it rarely developed drug resistance to cephalosporins and non-β-lactamase antibiotics. Over 99% of moraxella catarrhalis are still sensitive to β-lactamase antibiotics except penicillin and ampicillin and they are 100% sensitive to newly-launched macrolides and quinolones. The oral cephalosporins do not have any effect on atypical mycobacteria such as Mycoplasma pneumoniae but new quinolones and macrolides are very effective. Intravenous s[1] [2] [3] 下一页
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