Trends in empirical chemotherapy of bacterial meningitis in children aged more than 4 months in Japan: a survey from 1997 through 2008
Trends in empirical chemotherapy of bacterial meningitis in children aged more than 4 months in Japan: a survey from 1997 through 2008
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日本 4 个月以上儿童细菌性脑膜炎经验化疗的趋势：1997 年至 2008 年的一项调查
DOI：
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发表时间：
2011
影响因子：
2.2
通讯作者：
K. Sunakawa
中科院分区：
文献类型：
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作者：
Fuminori Sakai;H. Hanaki;Yurika Ikeda;Yuriko Hirao;M. Nonoyama;S. Iwata;Yoshitake Sato;H. Akita;T. Nakae;K. Sunakawa
细菌性脑膜炎是儿科临床的一个严重问题，因此需要紧急和经验性的化疗。我们对1997年至2008年1,116例年龄大于4个月的经验性化疗患者进行了问卷调查。这些年来，在不到30%的病例中进行了单一抗生素治疗，而在70%以上的病例中进行了两种抗生素的联合治疗。使用的主要抗生素为头孢菌素类、碳青霉烯类和氨苄青霉素。1997-2000年，74.7-82.7%的病例联合使用氨苄西林和头孢菌素，但此后急剧下降，2004-2008年为0-13.8%。然而，碳青霉烯和头孢菌素的联合使用弥补了下降，从1998-1999年的3.8-6.6%增加到2005-2008年的79.5-89.9%。头孢菌素类、碳青霉烯类和氨苄青霉素在两药联合治疗中的使用细分如下。(i)1997-2001年，头孢噻肟的使用率为61.8%-75.3%，但下降到近50%，相当于2003-2008年头孢曲松的使用水平。(ii)氨苄青霉素的使用从1997-2000年的74.7-92.3%下降到2008年的4.6%，而碳青霉烯类的使用弥补了这一下降水平。总体而言，第三代头孢菌素类和碳青霉烯类联合化疗似乎是可行的。本报告中的讨论包括日本和美国在病原体流行率和抗生素使用方面的差异。这些研究提供了日本儿童脑膜炎治疗趋势的信息，并将有助于未来经验性化疗的设计。
Bacterial meningitis is a serious problem in pediatric clinics and, therefore, needs urgent and empirical chemotherapy. We investigated 1,116 cases of empirical chemotherapy of patients aged older than 4 months from 1997 through 2008 by sending questionnaires. A single antibiotic treatment was carried out in less than 30% of the cases throughout the years, whereas the combination of two antibiotics had been practiced in more than 70% of the cases. The main antibiotics used were cephalosporins, carbapenems, and ampicillin. Combinatory use of ampicillin and cephalosporin was carried out in 74.7–82.7% of cases in 1997–2000, but sharply declined thereafter to 0–13.8% in 2004–2008. However, the combination of carbapenem and cephalosporin compensated for the decline, increasing from 3.8–6.6% in 1998–1999 to 79.5–89.9% in 2005–2008. The breakdown in the use of cephalosporins, carbapenems, and ampicillin in two-drug combinatory therapy was as follows. (i) Use of cefotaxime was 61.8–75.3% in 1997–2001, but decreased to nearly 50%, equivalent to the level of ceftriaxone use in 2003–2008. (ii) Use of ampicillin dropped from 74.7–92.3% in 1997–2000 to 4.6% in 2008, and this decreased level was compensated for by the use of carbapenems. Overall, combinatory chemotherapy of the third-generation cephalosporins and carbapenems seems to be practical. The discussion in this report includes the difference between Japan and the United States in the prevalence of the causative agents and the use of antibiotics. These studies provide information on trends in the treatment of children’s meningitis in Japan and will be useful for the design of future empirical chemotherapy.
肺炎球菌对万古霉素的耐受性：分子标记检测和临床影响评估。
DOI：
10.1086/424467
发表时间：
2004
期刊：
The Journal of infectious diseases.
影响因子：
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作者：
Rodriguez,CarinaA;Atkinson,Robyn;Bitar,Wally;Whitney,CynthiaG;Edwards,KathrynM;Mitchell,Lauren;Li,Juan;Sublett,Jack;Li,Chin-Shang;Liu,Tiebin;Chesney,PJoan;Tuomanen,ElaineI
通讯作者：
Tuomanen,ElaineI