淋病奈瑟菌对头孢菌素和阿奇霉素耐药性的研究进展

世界范围内出现了淋病奈瑟菌对一线治疗抗菌药物低敏、耐药的情况,尤其是对广谱头孢菌素和阿奇霉素的耐药性已经引起了人们的担忧。许多地区均出现了淋病奈瑟菌对广谱头孢菌素和（或）阿奇霉素高水平耐药的报告,为淋病联合治疗方案敲响了警钟。淋病奈瑟菌的耐药机制复杂,主要涉及到抗菌药物靶点的改变、药物内流减少和外排增加。各机制之间还存在某些依赖或协同效应。对淋病奈瑟菌耐药性的深入研究,有助于指导临床合理使用抗菌药物,延缓淋病奈瑟菌的耐药趋势。     

头孢菌素类抗生素不良反应类型及合理用药对策

目的分析头孢菌素类抗生素不良反应类型及合理用药对策。方法选择2018年12月-2019年12月曲靖市第一人民医院头孢菌素类抗生素引发不良反应的患者68例,回顾性分析不良反应的具体类型、原因及涉及的药物,并据此制定合理用药措施。结果68例患者不良反应类型中,胃肠道反应占比最高为60.29%,其次是变态反应占比为25.00%;不良反应原因中未进行药敏试验占比最高为63.24%,其次是超剂量用药占比为26.47%;头孢曲松引发的不良反应占比最高为33.82%,其次是头孢他啶和头孢唑林,分别占25.00%、23.53%。结论强制性开展药敏试验,强化医务人员业务水平,落实不良反应上报制度,均能减少头孢菌素类抗生素不良反应,保证治疗效果。     

三种头孢类抗生素治疗下呼吸道感染的成本-效果分析

目的 评价三种头孢菌素类药物治疗下呼吸道感染的疗效及经济效果。方法 选择下呼吸道感染患者132例,随机分为三组,分别给予头孢曲松钠、头孢唑肟钠、头孢吡肟钠治疗,观察各组疗效并应用药物经济学方法进行成本-效果分析。结果 三组治疗有效率分别为77.78%、91.11%、90.48%,不良反应发生率分别为8.89%、6.67%、9.52%,成本-效果比分别为13.47、30.94、28.60。结论 药物经济学分析结果为头孢曲松钠优于头孢唑肟钠和头孢吡肟钠。     

Comparative efficacy and safety evaluation of cefaclor VS amoxycillin + calvulanate in children with Acute Otitis Media (AOM)

Acute Otitis Media (AOM) is the most frequent respiratory tract infection of infancy and childhood that is treated with antimicrobial agents. The most common causative pathogens includeStreptococcus pneumoniae, Hemophilus influenzae andMoxarella catarrhalis, and therefore antibacterial management should target against these isolates. Cefactor, a congener of cephalexin monohydrate, is a semisynthetic cephalosporin antibiotic. It is an orally active cephalosporin which has demonstrated activity against a wide range of organismsin vitro. Present study is designed as a multicentric prospective trial to study and compare the efficacy and safety of cefaclor versus amoxicillin+clav in children with acute otitis media. One hundred and sixty seven patients were evaluated for efficacy endpoints in the cefaclor arm comprised of 104 males and 63 females with a mean age of 5.74±2.80 years and 185 patients in the amoxy-clav group comprised of 118 males and 67 females with a mean age of 4.93±2.92 years. Both cefaclor and amoxy-clav caused a significant improvement in all the signs and symptoms after a 10-day treatment period. However, between-the-group comparisons showed that the reduction i nmost of the symptoms was significantly more in cefaclor arm as compared to amoxicillin-clav arm. The clinical success (clinical cure + improvement) at the end of therapy was significantly more in cefaclor arm: 98% with cefaclor versus 85% with amoxicillin+clav, p<0.05 (Table 3). Failure cases were prescribed other antibiotics according to the culture sensitivity reports, as rescue medication. Bacterial eradication rates were largely consistent with clinical responses. Bacteriological eradication was seen in 95% of patients in cefaclor group and 78% of patients in amoxicillin+clav group. In conclusion, cefaclor is a well tolerated and effective antibacterial option for acute otitis media in children and it is superior to the combination of amoxicillin+clav in efficacy and tolerability in acute AOM. Moreover, its expanded spectrum of activity, ability to achieve adequate concentrations in tissues, suitability for twicedaily dosing, and proven tolerability suggest that it is a good alternative to agents traditionally used in acute otitis media.     

头孢地尼对儿科呼吸道常见致病菌体外抗菌活性的研究

目的探讨头孢地尼对小儿呼吸道常见致病菌的体外抗菌活性。方法E-test法测定头孢地尼对肺炎链球菌等7种细菌共380株的最低抑菌浓度(MIC),并与头孢克洛作对比研究。结果青霉素敏感肺炎链球菌(PSSP)对头孢地尼和头孢克洛均敏感,青霉素耐药肺炎链球菌(PRSP)均耐药,青霉素中介肺炎链球菌(PISP)对头孢地尼敏感率72．0％,头孢克洛为58．0％。不产β内酰胺酶的流感嗜血杆菌(HI)对两者均敏感,但对产β内酰胺酶HI,头孢地尼敏感率85．0％、头孢克洛70．0％,MIC90值头孢地尼(1．5mg/L)明显低于头孢克洛(256．0mg/L)。卡他莫拉菌(MC)、A组链球菌(GAS)和甲氧西林敏感的金黄色葡萄球菌(MSSA),以及不产超广谱B内酰胺酶(ESBLs)的大肠埃希菌(E．coli)、肺炎克雷伯菌(k.pn),对头孢地尼抗菌活性均优于头孢克洛。对产ESBLs的菌株,两者均无抗菌活性。结论头孢地尼对PSSP、PISP、HI、GAS、MC、MSSA以及ESBLs(-)k.pn和E．coli均有强大的体外抗菌活性。     

Efficacy and tolerability assessment of cefprozil in children with acute otitis media

Young children contract as many as six to eight upper respiratory tract viral infections per year, and these infections frequently lead to secondary bacterial infections such as acute otitis media and sinusitis. Cefprozil is an orally active third generation cephalosporin which has demonstrated activity against the gram-positive organismsStreptococcus pyogenes,pneumoniae andagalactiae and against methicilin-susceptibleStaphylococcus aureus. Cefprozil is also active against variousgramves and certainanaerobic organisms, and is stable to hydrolysis by a number of β-lactamases. Present study is an effort to study the efficacy and safety of cefprozil in children with acute otitis media. Three hundred and thirty four children aged 6 months through 12 years with clinical symptoms and tympanic membrane signs of AOM received cefprozil 30 mg/kg/day in two divided doses per day for 10 days. Clinically, 96.6% patients were cured, 2.4% improved and there was failure of therapy in 1% of the patients. There was no need for any rescue medication and any change in antibiotic in any patient. A satisfactory bacteriological outcome was (i.e. cure, presumed cure, and cure plus reinfection with a different pathogen) was achieved in 95% of patients. In conclusion, cefprozil is a well tolerated and effective drug for acute otitis media in children. Moreover, its expanded spectrum of activity, ability to achieve adequate concentrations in tissues, suitability for twice-daily dosing, and proven tolerability suggest that it is a better alternative to agents conventionally used in acute otitis media     

536例头孢菌素类抗生素不良反应报告分析

目的 通过监测分析2004年1月-2005年12月山西省药品不良反应中心收到的药品不良反应报告中头孢菌素类抗生素所致不良反应及其相关因素，提示应正确使用头孢素类抗生素，以减少不良反应的发生。方法 采用回顾性调查方法对收到的头孢菌素类抗生素所致536例不良反应报告进行统计分折。结果 不良反应涉及药品18种，排前3位的是头孢曲松、头孢哌酮、头孢噻肟。药品不良反应累及人体的9个系统，比例最高的不良反应为变态反应。分析头孢菌素类抗生素的主要不良反应发生机制，为临床正确使用提供理论依据。结论 应关注头孢菌素类抗生素的不良反应，提高合理用药水平。     

头孢菌素类药物不良反应及对策

头孢菌素类药物因其耐酶、耐酸、杀菌谱广和杀菌力强而被广泛应用于临床。近年来随着此类药物的广泛应用,不良反应的发生率逐年增多。为此,本文重点分析了头孢菌素类药物不良反应发生的原因,并指出了一些预防不良反应发生的对策。