Treatment of Legionnaires' disease
Treatment of Legionnaires' disease
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DOI：
10.2165/00003495-200565050-00003
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发表时间：
2005-01-01
期刊：
影响因子：
11.5
通讯作者：
Amsden, GW
中科院分区：
文献类型：
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作者：
Amsden, GW
军团病是一种肺炎，通常由嗜肺军团菌引起，其严重程度从轻微到非常严重不等。虽然它通常是在社区中获得的，但也可以很容易地从未经适当净化的水源获得。虽然历史上最初的治疗一直是红霉素，但目前的病例系列和治疗建议建议门诊患者立即接受以下抗菌药物之一的治疗：阿奇霉素、红霉素、克拉霉素、特利霉素、多西环素或超广谱氟喹诺酮。如果症状严重到需要住院治疗，那么患者应该接受阿奇霉素或超广谱氟喹诺酮类药物的治疗，然后逐步服用口服制剂，以完成疗程。对于更严重的感染，静脉/口服阿奇霉素的疗程可能较短，为7-10天，但其他抗菌药物应该总共服用10-21天，并在出现时尽快开始治疗，以优化结果。
Legionnaires' disease is pneumonia, usually caused by Legionella pneumophila, which can range in severity from mild to quite severe. While it is commonly acquired in the community, it can just as easily be acquired nosocomially from water sources that have not been appropriately decontaminated. While historically initial treatment was always with erythromycin, current case series and treatment recommendations suggest that outpatients receive immediate treatment with one of the following antibacterials: azithromycin, erythromycin, clarithromycin, telithromycin, doxycycline or an extended-spectrum fluoroquinolone. If the symptoms are severe enough to warrant hospitalisation then the patient should receive treatment with parenteral azithromycin or extended-spectrum fluoroquinolones followed by step-down to oral formulations to complete the regimens. While a shorter course of 7-10 days for more severe infections may be possible for intravenous/oral azithromycin, other antibacterials should be administered for a total of 10-21 days and started as soon as possible upon presentation to optimise outcomes.