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在第一次军团菌感染暴发流行期间,并未经过严格的常规临床试验检验的红霉素却成为治疗该感染性疾病的选择药物。随着红霉素治疗失败率的上升、不良反应的增多以及药物相互作用等问题的不断出现,人们在20世纪90年代开始考虑用其他药物(如新大环内酯类和喹诺酮类)替代红霉素治疗军团菌感染。19项体外细胞内模型和7项动物模型试验的比较结果显示,喹诺酮类对军团菌的体内外活性均优于大环内酯类。458例军团菌感染者参与的3项非随机临床对照试验显示,与大环内酯类(红霉素、克拉霉素,未涉及阿奇霉素)相比,喹诺酮类(主要是左氧氟沙星)无论在退热时间、住院时间或是对相关并发症的控制等方面都更具潜在优势。鉴于此,作者推荐用喹诺酮类代替红霉素来对付军团菌感染。
During the first Legionella infection outbreak, erythromycin, which has not undergone rigorous routine clinical trials, became the drug of choice for the treatment of the infectious disease. With the increasing failure rate of erythromycin treatment, the increase of adverse reactions and the continuous emergence of drug interactions, people began to consider using other drugs (such as neo-macrolides and quinolones) instead of red in the 1990s Mycotoxin treatment of Legionella infection. Comparisons of 19 in vitro cell models and seven animal model tests showed that quinolones were superior to the macrolides in both in vitro and in vivo activity against Legionella. Three non-randomized controlled clinical trials involving 458 Legionella patients showed that quinolones (mainly levofloxacin), compared with macrolides (erythromycin, clarithromycin, not azithromycin) Time, length of stay, or control of related complications. In view of this, the authors recommend the use of quinolones instead of erythromycin to combat Legionella infection.