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氯霉素自1948年用于临床以来,一直为伤寒和副伤寒的首选药。它虽对大多数革兰氏阳性与阴性细菌、衣原体和立克次氏体也有强的抑制作用,但由于对造血系统的毒性,在使用上受到严格限制。近年,发现肺炎杆菌、流感杆菌对氨苄青霉素产生耐药性,由它们引起的感染(如小儿肺炎和脑膜炎),用氯霉素治疗效果很好,而氨苄青霉素则无效。因此氯霉素再度被临床重视与选用。为发挥其优势,达安全用药之目的,再将氯霉素的主要毒性及其产生机理讨论如下。
Chloramphenicol has been the drug of choice for typhoid and paratyphoid since its clinical use in 1948. Although it has a strong inhibitory effect on most Gram-positive and -negative bacteria, Chlamydia and Rickettsia, it is severely restricted in its use due to its toxicity to the hematopoietic system. In recent years, it has been found that Klebsiella pneumoniae and influenza bacilli are resistant to ampicillin, infections caused by them (such as pneumonia and meningitis in children), treatment with chloramphenicol is very effective, and ampicillin is ineffective. Therefore, chloramphenicol once again clinically attention and selection. To play its advantages, up to the purpose of safe medication, then the main toxicity of chloramphenicol and its mechanism discussed below.