【作者】 孟现民； 沈银忠； 张永信；

【Author】 MENG Xian-min~(1,2),SHENG Yin-zhong~2,ZHANG Yong-xin~(3*) (1.School of Pharmacy,Fudan University,Shanghai,201203;2.Public Health Clinical Center Affiliated to Fudan University,Shanghai,201508;3.Huashan Hospital,Shanghai,200040,China)

【机构】 复旦大学药学院； 复旦大学附属公共卫生临床中心； 复旦大学附属华山医院；

【摘要】 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。由此,也使碳青霉烯类等更新抗菌药物的用量增加,致病原菌更加耐药,使一些细菌感染的治疗更加困难。不过因此而轻视第三代头孢菌素的临床价值也是不正确的。综合致病菌种类、药敏结果、感染特点与患者状况等因素,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。本文从品种情况、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。更多还原

【Abstract】 The third-generation cephalosporins which have a lot of advantages such as excellent pharmacological characteristics and low toxicity,play an important role in the treatment of bacterial infections, while inappropriate and irrational use of it has led to a gradual increase of the proportion of strains producing ESBLs and rates of bacterial resistance in recent years.Due to lack of sober understanding of this problem,some clinicians were preferred to use newer antimicrobial agents,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 treat.However,it is incorrect to underestimate the clinical value of the third-generation cephalosporins at present,because the third generation of cephalosporins are still of great importance in clinical treatments if we use them properly.In this paper,we reviewed the third-generation cephalosporins on variety, advantages and disadvantages,bacterial resistance and clinical application.更多还原