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J Antimicrob Chemother ：阿莫西林比克林霉素更能有效预防感染性心内膜炎

2015-05-20 MedSci MedSci原创

药物不良发应阿莫西林克林霉素牙科
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J Antimicrob Chemother ：阿莫西林比克林霉素更能有效地预防感染性心内膜炎的发生英国的一项新研究表明患者在接受牙科之前预防性使用阿莫西林来预防感染性心内膜炎发生的效果优于克林霉素。该研究于2015年4月29日在线发表于J Antimicrob Chemother. 牙科治疗之前预防性使用抗生素一直是预防感染性心内膜炎发生的主要手段，然而，预防性使用抗生素却存在着诸多的


英国的一项新研究表明患者在接受牙科之前预防性使用阿莫西林来预防感染性心内膜炎发生的效果优于克林霉素。该研究于2015年4月29日在线发表于J Antimicrob Chemother. 

牙科治疗之前预防性使用抗生素一直是预防感染性心内膜炎发生的主要手段，然而，预防性使用抗生素却存在着诸多的不良药物反应。本研究的目的是为了确定预防性使用阿莫西林或克林霉素后感染性心内膜炎的发生率及两种药物的不良药物反应。

从NHSBSA公司获得2004年2月至2014年英国预防性使用抗生素的处方数据，并从药品和保健产品监管署的黄卡报道的预防性应用抗生素标准剂量（阿莫西林3g，口服，对青霉素过敏者口服克林霉素600mg）后出现药物不良反应的数据。

结果发现，预防性应用阿莫西林后不良反应发生率为无一人发生了致命的不良反应/百万处方(实际上是近3百万例处方中无一例致命反应)，22.62例非致命反应/百万处方。而预防性应用克林霉素后不良反应的发生率为13例致命反应以及149例非致命反应/百万处方。使用克林霉素后最常见的不良反应为艰难梭菌感染。

在英国，关于预防性应用抗生素后发生不良反应的报道较少，尤其是在应用阿莫西林时，其发生不良药物反应的几率小于我们先前的预期。这表明，对于无阿莫西林过敏史的患者，预防性应用阿莫西林相对来说较安全。而应用克林霉素时，发生致命性及与艰难梭菌相关的非致命性不良药物反应的概率很大，明显高于我们的预期。

原始出处：

Thornhill MH, Dayer MJ, Prendergast B, Baddour LM, Jones S, Lockhart PB.
Incidence and nature of adverse reactions to antibiotics used as endocarditis prophylaxis.J Antimicrob Chemother. 2015 Apr 29. pii: dkv115

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    2016-04-21 12498974m61暂无昵称

    #内膜#

    0

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    2016-04-08 jiafufeng@yaho

    #CRO#

    0

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    2015-12-03 ms3025846204744509

    #克林霉素#

    0

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    2015-11-06 xjy02

    #Micro#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1708316, encodeId=9cf41e0831606, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Apr 21 13:11:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857354, encodeId=6a02185e354cf, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Apr 08 00:11:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030636, encodeId=36f920306361b, content=<a href='/topic/show?id=5ef528884e9' target=_blank style='color:#2F92EE;'>#克林霉素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28884, encryptionId=5ef528884e9, topicName=克林霉素)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Thu Dec 03 06:11:00 CST 2015, time=2015-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084128, encodeId=be2020841289d, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Fri Nov 06 19:11:00 CST 2015, time=2015-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655338, encodeId=a9c71655338d3, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Fri Feb 26 19:11:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24869, encodeId=17542486902, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Mon May 25 19:09:00 CST 2015, time=2015-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24625, encodeId=7c4c2462580, content=依然是抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9e0b1603164, createdName=lovejing, createdTime=Sat May 23 23:53:00 CST 2015, time=2015-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350677, encodeId=51f613506e797, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 12:11:00 CST 2015, time=2015-05-22, status=1, ipAttribution=)]
    2016-02-26 charl1234575

    #感染性#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1708316, encodeId=9cf41e0831606, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Apr 21 13:11:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857354, encodeId=6a02185e354cf, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Apr 08 00:11:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030636, encodeId=36f920306361b, content=<a href='/topic/show?id=5ef528884e9' target=_blank style='color:#2F92EE;'>#克林霉素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28884, encryptionId=5ef528884e9, topicName=克林霉素)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Thu Dec 03 06:11:00 CST 2015, time=2015-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084128, encodeId=be2020841289d, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Fri Nov 06 19:11:00 CST 2015, time=2015-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655338, encodeId=a9c71655338d3, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Fri Feb 26 19:11:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24869, encodeId=17542486902, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Mon May 25 19:09:00 CST 2015, time=2015-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24625, encodeId=7c4c2462580, content=依然是抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9e0b1603164, createdName=lovejing, createdTime=Sat May 23 23:53:00 CST 2015, time=2015-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350677, encodeId=51f613506e797, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 12:11:00 CST 2015, time=2015-05-22, status=1, ipAttribution=)]
    2015-05-25 huaxipanxing

    看看

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1708316, encodeId=9cf41e0831606, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Apr 21 13:11:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857354, encodeId=6a02185e354cf, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Apr 08 00:11:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030636, encodeId=36f920306361b, content=<a href='/topic/show?id=5ef528884e9' target=_blank style='color:#2F92EE;'>#克林霉素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28884, encryptionId=5ef528884e9, topicName=克林霉素)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Thu Dec 03 06:11:00 CST 2015, time=2015-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084128, encodeId=be2020841289d, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Fri Nov 06 19:11:00 CST 2015, time=2015-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655338, encodeId=a9c71655338d3, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Fri Feb 26 19:11:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24869, encodeId=17542486902, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Mon May 25 19:09:00 CST 2015, time=2015-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24625, encodeId=7c4c2462580, content=依然是抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9e0b1603164, createdName=lovejing, createdTime=Sat May 23 23:53:00 CST 2015, time=2015-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350677, encodeId=51f613506e797, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 12:11:00 CST 2015, time=2015-05-22, status=1, ipAttribution=)]
    2015-05-23 lovejing

    依然是抗生素

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1708316, encodeId=9cf41e0831606, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Apr 21 13:11:00 CST 2016, time=2016-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857354, encodeId=6a02185e354cf, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Apr 08 00:11:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030636, encodeId=36f920306361b, content=<a href='/topic/show?id=5ef528884e9' target=_blank style='color:#2F92EE;'>#克林霉素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28884, encryptionId=5ef528884e9, topicName=克林霉素)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Thu Dec 03 06:11:00 CST 2015, time=2015-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084128, encodeId=be2020841289d, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Fri Nov 06 19:11:00 CST 2015, time=2015-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655338, encodeId=a9c71655338d3, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Fri Feb 26 19:11:00 CST 2016, time=2016-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24869, encodeId=17542486902, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Mon May 25 19:09:00 CST 2015, time=2015-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=24625, encodeId=7c4c2462580, content=依然是抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9e0b1603164, createdName=lovejing, createdTime=Sat May 23 23:53:00 CST 2015, time=2015-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350677, encodeId=51f613506e797, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri May 22 12:11:00 CST 2015, time=2015-05-22, status=1, ipAttribution=)]
    2015-05-22 zhaojie88

    #心内膜炎#

    0