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Randolph医生问:我在门诊中曾经遇到一些罹患可能由肺炎球菌引起的复发性呼吸道感染(特别是鼻窦炎和/或中耳炎)的幼儿.例如,我最近诊治了两例哮喘和复发性鼻窦炎患儿(1例5岁,另1例8岁),两例都曾接受许多疗程的抗生素治疗,目前,我正在考虑给他们作羟氨苄青霉素化学预防.不知肺炎球菌菌苗接种对这些患儿是否有帮助?在美国儿科学会或疾病控制和预防中心的现有规定中没有包含这个适应证.请问,在化学预防时可加用菌苗接种吗?或者可用菌苗接种代替化学预防吗?Giebink医生(明尼苏达大学医学院)答:肺炎球菌是儿童和成人急性和亚急性鼻窦炎的主要病因,而复发性鼻窦炎则是反应性气道病患儿哮喘反复发作的触发因素.因此,减少急性或亚急性鼻窦炎的措施都可减轻哮喘病情.抗生素预防和肺炎球菌菌苗接种都是合适的措施.然而,尚无临床对照试验对这两种预防方法的效果进行严格考核.
Dr. Randolph Q: I have had some outpatient visits with young children who have recurrent respiratory infections (especially sinusitis and / or otitis media) that may be caused by pneumococcal disease. For example, I recently diagnosed two cases of asthma and recurrent sinusitis Children (1 in 5 years and 1 in 8 years), both of whom received antibiotics for many courses of treatment, are currently considering their use of amoxicillin for chemical prophylaxis. I do not know if pneumococcal vaccine is given to these children Is this helpful? The indication is not included in the current guidelines of the American Academy of Pediatrics or the Centers for Disease Control and Prevention. Can I use bacterin inoculation when doing chemical prophylaxis or can I use bacterin inoculation instead of chemical prophylaxis? Giebink Doctors (University of Minnesota Medical School) A: Pneumococci are the leading cause of acute and subacute sinusitis in children and adults, and recurrent sinusitis is a trigger for recurrent asthma in children with reactive airways disease. Therefore, reducing acute Or subacute sinusitis can reduce asthma, antibiotic prophylaxis and pneumococcal vaccination are appropriate measures, however, there is no clinical control trial of these two pre- Anti-method effect of rigorous examination.