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慢性支气管炎急性发作 (AECB)是导致严重疾病和死亡的主要原因之一。约半数AECB是由致病菌引起的 ,传统抗生素经验疗法在对付AECB中发挥着重要作用。然而 ,近年来出现的几起严重事件已使针对治疗AECB的抗菌药的选择明显复杂化。过去十余年中成功开发的新氟喹诺酮的体外抗菌谱包括了AECB的所有主要致病菌 ,因此 ,它们在理论上非常适合AECB的治疗 ,其药动学和药效学性质也的确优于其它许多抗菌药。这类抗菌药的临床有效率与其它类抗菌剂相当 ,其细菌清除率高于或相当于后者。但是 ,它们在临床试验阶段表现出的理论上的优越性并没有也不可能对其罕见的潜在严重不良反应作出评价。曲伐沙星和替马沙星事件已经开始动摇临床医生对氟喹诺酮类抗菌药的信心。尽管如此 ,把具有优秀抗菌活性、药效学和药动学性质的抗菌药 ,如新氟喹诺酮作为治疗存在危险因素的难治性或须入院治疗并采取特殊护理措施的AECB患者的首选药物是合理的
Acute episode of chronic bronchitis (AECB) is one of the leading causes of serious illness and death. About half of AECBs are caused by pathogenic bacteria, and traditional antibiotic empirical therapies play an important role in countering AECB. However, several serious events that have occurred in recent years have significantly complicated the choice of antimicrobial agents for treating AECB. The in vitro antibacterial spectrum of the new fluoroquinolones developed over the past decade or so includes all of the major pathogens of AECB and therefore they are ideally suited for the treatment of AECB with indeed superior pharmacokinetic and pharmacodynamic properties Many other antibacterials. The clinical effectiveness of such antibacterial drugs and other types of antibacterial agents, the bacterial clearance rate higher than or equal to the latter. However, the theoretical superiority they show during clinical trials is not and can not be evaluated for their rare potential serious adverse reactions. Trovafloxacin and tebufloxacin have begun to shake the clinician’s confidence in fluoroquinolone antibacterials. Nevertheless, antibacterials with excellent antibacterial activity, pharmacodynamic and pharmacokinetic properties, such as neofluoroquinolone, are the preferred drugs for AECB patients who are refractory to risk factors or are hospitalized and given special care reasonable