第三代头孢菌素临床应用的定位

第三代头孢菌素品种多、药理学特点优良、安全性好,在细菌性感染的防治中发挥着重要的作用。但不规范的使用导致产超广谱β-内酰胺酶(ESBLs)菌株的检出率及细菌耐药率有增高的趋势,也使碳青霉烯类等新型抗菌药物的用量增加,导致病原菌耐药加剧,使一些细菌感染的治疗更加困难。但因此而轻视第三代头孢菌素的临床价值是不正确的。综合致病菌种类、药敏试验结果、感染特点与病人状况等因素,审慎选择和使用第三代头孢菌素,充分发挥其临床应用价值,在当下仍具有积极的意义。本文从药物品种、优缺点、主要致病菌的耐药情况以及临床定位等几个方面,对第三代头孢菌素作一梳理,供临床医师、药师参考。

Clinical orientation of the third generation cephalosporin

The third generation cephalosporin having such advantages as excellent pharmacological characteristics and low toxicity,play an important role in the treatment of bacterial infections.However,irrational use of them has led to a gradual increase in the proportion of strains producing extended-spectrum β-lactamases(ESBLs) and rate of bacterial resistance in recent years.Due to lack of sober understanding of this problem,some clinicians preferred to use new antibacterials,such as carbapenems,to treat bacterial infections.The consequence is that the bacteria become more and more resistant,and the infections caused by resistant bacteria become more difficult to be curbed.However,it is incorrect to underestimate the clinical value of the third generation cephalosporin.Because the third generation cephalosporin are still great importance in clinical treatments if we use them properly.In this paper,the varieties,advantages and disadvantages,bacterial resistance and clinical application of the third generation cephalosporin were reviewed.