长期以来，大环内酯类抗菌药物一直是百日咳抗菌治疗的首选药物。但是，近十年来，国内临床分离的百日咳鲍特菌常对大环内酯类抗菌药物耐药，与推荐首选大环内酯类治疗已呈明显矛盾。因此作者建议国内当前百日咳抗菌治疗首选甲氧苄啶-磺胺甲唑(TMP-SMZ)，根据年龄和体重确定给药剂量，并坚持用药14 d；如不能使用TMP-SMZ，可尝试足量、足疗程选用β-内酰胺类药物，其效果需谨慎评估；还应积极评估喹诺酮类、四环素类等其他抗菌药物清除体内百日咳鲍特菌的作用，以治疗成人百日咳或应对将来新出现的耐药菌。 For a long time, macrolides have been the first choice for the antibacterial treatment for pertussis.However, in the past decade, resistance to macrolide antimicrobials has been common in clinically isolated Bordetella pertussis in China, which is in contradiction with the recommended macrolide treatment.Therefore, Trimethoprim-Sulfamethoxazole (TMP-SMZ) is suggested as the first choice for antibacterial treatment for pertussis in China, with a dosage determined according to age and body weight, lasting 14 days.If TMP-SMZ cannot be used, full-dose and full-course β-lactam antimicrobials may be used, of which the effects should be assessed carefully.The impact of other antibacterial drugs, such as quinolones and tetracyclines, on the elimination of Bordetella pertussis should also be evaluated as soon as possible to treat adult pertussis and potential cases caused by drug-resistant bacteria in future.
Abstract
For a long time, macrolides have been the first choice for the antibacterial treatment for pertussis.However, in the past decade, resistance to macrolide antimicrobials has been common in clinically isolated Bordetella pertussis in China, which is in contradiction with the recommended macrolide treatment.Therefore, Trimethoprim-Sulfamethoxazole (TMP-SMZ) is suggested as the first choice for antibacterial treatment for pertussis in China, with a dosage determined according to age and body weight, lasting 14 days.If TMP-SMZ cannot be used, full-dose and full-course β-lactam antimicrobials may be used, of which the effects should be assessed carefully.The impact of other antibacterial drugs, such as quinolones and tetracyclines, on the elimination of Bordetella pertussis should also be evaluated as soon as possible to treat adult pertussis and potential cases caused by drug-resistant bacteria in future.
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