在抗青素耐药性肺炎球菌脑膜炎中,氨基醇治疗失败
1Department of Paediatrics, Baragwanath Hospital, Johannesburg, South Africa.
Lancet (London, England)
|February 15, 1992
概括
氨基醇在治疗由耐青素肺炎 estreptococcus (PRSP) 引起的脑膜炎方面无效. 患有PRSP脑膜炎的患者的治疗结果明显较差,突出显示了需要替代性治疗方法的需要,如头素.
科学领域:
- 传染性疾病 传染性疾病
- 儿科 儿科 儿科
- 药理学 药理学是指药理学的学科.
背景情况:
- 脑膜炎的治疗通常包括青素和氨基醇.
- 全球抗青素耐药性肺炎菌株 (PRSP) 的增长率引发了对治疗疗效的担忧.
- 氨基醇对PRSP脑膜炎的有效性仍然在很大程度上是未知的.
研究的目的:
- 为了前性地评估用青素加氨基醇治疗的肺炎球菌性脑膜炎儿童.
- 为了比较青素敏感的S. pneumoniae (PSSP) 和PRSP脑膜炎之间的结果.
- 评估目前用于PRSP脑膜炎的氨基醇敏感性定义的适用性.
主要方法:
- 在27个月内对68名患有肺炎球菌脑膜炎的儿童进行前性评估.
- 在PSSP和PRSP组之间对临床结果 (死亡,神经缺陷,临床反应) 的比较.
- 与治疗结果相关的氨基醇最小杀菌度 (MBC) 的分析.
主要成果:
- 在25名患有PRSP脑膜炎的儿童中,20名 (80%) 的结果不令人满意.
- 在43名患有PSSP脑膜炎的儿童中,有14名 (33%) 患有不良结果 (p < 0.001).
- 在PRSP分离物中较高的氨基醇MBC与边界脑脊髓液的杀菌活性和治疗失败相关.
结论:
- 氨醇与PRSP脑膜炎的高治疗失败率有关.
- 目前对氨基醇敏感性的定义可能不适合PRSP.
- 对PRSP脑膜炎建议使用替代抗生素,如第三代类抗生素.
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