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呼吸道感染对公共卫生的影响日益严重,其中下呼吸道感染是导致严重疾病和死亡的主要原因之一。临床上的绝大多数抗生素处方与呼吸道感染有关,这可能是细菌的耐药性在社区和院内迅速增加之故。因此,这又成为促进药物化学家加快研发新药物(如新氟喹诺酮)的主要推动力。新氟喹诺酮对大多数重要的呼吸道感染病原菌(包括典型和非典型病原菌)具有良好的抗菌活性,其药效学和药动学性质对它们的临床疗效和细菌学效果具有非常重要的影响。该类药物具有浓度依赖性杀菌作用和持续性抗菌后效应,而且其性价比也颇高。在达到同样目的的情况下,氟喹诺酮疗法具有治疗费用低廉的特点。各种临床治疗指南均将氟喹诺酮列为下呼吸道感染(LRTIs)经验疗法中可选择的药物之一。本文综述了近年来新氟喹诺酮细菌学和临床疗效方面的最新数据,并分析了过度使用该类药物的潜在危害。
The impact of respiratory infections on public health is becoming increasingly serious. Among them, lower respiratory tract infection is one of the major causes of serious illness and death. The vast majority of antibiotic prescriptions in the clinic are associated with respiratory infections, which may be due to the rapid increase in bacterial resistance in the community and in the hospital. This, in turn, has been a major driving force behind drug chemists in accelerating the development of new drugs such as neo-fluoroquinolones. New fluoroquinolones have good antibacterial activity against most of the major pathogenic bacteria of respiratory tract infections, including both classical and atypical pathogens, and their pharmacodynamic and pharmacokinetic properties have very important implications for their clinical efficacy and bacteriological effects. These drugs have a concentration-dependent bactericidal effect and sustained antibacterial effect, and its cost is also high. In achieving the same goal, fluoroquinolone therapy has the characteristics of low cost of treatment. Fluoroquinolones are among the options available for empirical treatment of lower respiratory tract infections (LRTIs) in a variety of clinical guidelines. This review summarizes recent data on the bacteriological and clinical efficacy of new fluoroquinolones and analyzes the potential hazards of overuse of these drugs.