从指南看呼吸喹诺酮类药物在下呼吸道感染中的治疗地位

The role of respiratory quinolones in the treatment of lower respiratory tract infection through the view of guideline

喹诺酮类药物经历了近60年的发展,呼吸喹诺酮类药物已经成为临床中最常用的抗感染药物之一,其在化学结构上的优化,使得这类药物与其他类抗菌药物相比,在抗菌谱、抗菌活性、耐药机制、药代动力学/药效学中均有不同程度的差异,而不同呼吸喹诺酮药物在上述药物特点上也存在差异,从而决定了在疗效上也有所不同。近十年来,由于病原菌耐药谱发生变化、抗感染治疗药物循证证据不断积累,国内外关于下呼吸道感染的指南和共识对于临床药物的推荐和建议也不断发展更新。本文综述了呼吸喹诺酮类药物特点及国内外指南对呼吸喹诺酮类药物治疗下呼吸道感染的推荐建议以及临床疗效,以便于临床医师、药师了解呼吸喹诺酮类药物,从而在临床治疗下呼吸道感染中能够优化管理,对临床工作有所助益。

Quinolone drugs have undergone nearly 60 years of development.Respiratory quinolone has become one of the most commonly used anti-infective drugs in the clinic.In terms of antibacterial spectrum,antibacterial activity,drug resistance mechanism,pharmacokinetics/pharmacodynamics,because of the chemical structure optimization of respiratory fluoroquinolones,there are different degrees of differences compared with other types of antibacterial drugs,and there are also differences among quinolone drugs.The characteristics of the drug itself determine that the efficacy of respiratory fluoroquinolones is different from other drugs and among respiratory fluoroquinolones.In the past decade,due to the change of drug resistance spectrum of pathogenic bacteria and the accumulation of evidence-based evidences of anti-infective drugs,the domestic and foreign guidelines and consensus on lower respiratory tract infection for clinical drug recommendations are also constantly updated.This article reviews the characteristics of respiratory quinolones and the recommendations and clinical effects of domestic and foreign guidelines on the treatment of lower respiratory tract infection with respiratory quinolones.In order to promote clinicians and pharmacists to understand respiratory quinolones,so as to optimize the management of clinical lower respiratory tract infection and provide help for clinical work.