国内当前百日咳治疗的抗菌药物选择之我见  

Thoughts on the selection of antimicrobials for current pertussis treatment in China

作　　者：姚开虎 孟庆红 史伟 袁林 胡亚红 Yao Kaihu;Meng Qinghong;Shi Wei;Yuan Lin;Hu Yahong(Key Laboratory of Major Diseases in Children,Ministry of Education,National Key Discipline of Pediatrics(Capital Medical University),Laboratory of Infection and Microbiology,Beijing Pediatric Research Institute,Beijing Children′s Hospital,Capital Me-dical University,National Center for Children′s Health,National Clinical Research Center for Respiratory Disease,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院,北京市儿科研究所感染与微生物研究室,儿科学国家重点学科,儿科重大疾病研究教育部重点实验室,国家呼吸系统疾病临床医学研究中心,北京100045

出　　处：《中华实用儿科临床杂志》2024年第2期85-88,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81973100);国家呼吸系统疾病临床医学研究中心呼吸专项(HXZX-202106)。

摘　　要：长期以来,大环内酯类抗菌药物一直是百日咳抗菌治疗的首选药物。但是,近十年来,国内临床分离的百日咳鲍特菌常对大环内酯类抗菌药物耐药,与推荐首选大环内酯类治疗已呈明显矛盾。因此作者建议国内当前百日咳抗菌治疗首选甲氧苄啶-磺胺甲唑(TMP-SMZ),根据年龄和体重确定给药剂量,并坚持用药14d;如不能使用TMP-SMZ,可尝试足量、足疗程选用β-内酰胺类药物,其效果需谨慎评估;还应积极评估喹诺酮类、四环素类等其他抗菌药物清除体内百日咳鲍特菌的作用,以治疗成人百日咳或应对将来新出现的耐药菌。For a long time,macrolides have been the first choice for the antibacterial treatment for pertussis.However,in the past decade,resistance to macrolide antimicrobials has been common in clinically isolated Bordetella pertussis in China,which is in contradiction with the recommended macrolide treatment.Therefore,Trimethoprim-Sulfamethoxazole(TMP-SMZ)is suggested as the first choice for antibacterial treatment for pertussis in China,with a dosage determined according to age and body weight,lasting 14 days.If TMP-SMZ cannot be used,full-dose and full-courseβ-lactam antimicrobials may be used,of which the effects should be assessed carefully.The impact of other antibacterial drugs,such as quinolones and tetracyclines,on the elimination of Bordetella pertussis should also be evaluated as soon as possible to treat adult pertussis and potential cases caused by drug-resistant bacteria in future.

关 键 词：百日咳 百日咳鲍特菌 耐药性 抗菌药物 治疗 

分 类 号：R516.6[医药卫生—内科学]