NEJM:阿奇霉素治疗可降低撒哈拉以南非洲地区儿童死亡风险

2018-04-26 zhangfan MedSci原创

在撒哈拉以南地区的学龄前儿童中进行阿奇霉素治疗可显著降低儿童死亡风险,特别是尼日尔,但这一策略的普及尚需考察耐药性的影响

近日研究人员考察了在撒哈拉以南的非洲地区广谱抗生素治疗对学龄前儿童死亡率的影响。

研究在马拉维、尼日尔和坦桑尼亚开展,参与者每年4次接受口服阿奇霉素(20mg每公斤体重)或安慰剂。研究终点为全因总死亡率以及国家特异性死亡率。

1533个地区,总计190238名儿童参与,随访323302年,试验完成率90.4%。接受阿奇霉素治疗的地区每1000随访年中死亡14.6人,其中马拉维9.1人,尼日尔22.5人,坦桑尼亚5.4人;而安慰剂组每1000随访年死亡16.5人,其中马拉维9.6人、尼日尔27.5人和坦桑尼亚5.5人。接受阿奇霉素治疗导致死亡率降低13.5%,其中马拉维降低5.7%、尼日尔18.1%和坦桑尼亚3.4%。1-5个月幼儿接受阿奇霉素治疗后效果更为显著,死亡率降低24.9%。阿奇霉素治疗一周内导致严重不良事件并不常见,组间不良事件发生率无显著差异。耐药性评估尚在进行中。

在撒哈拉以南地区的学龄前儿童中进行阿奇霉素治疗可显著降低儿童死亡风险,特别是尼日尔,但这一策略的普及尚需考察耐药性的影响。

原始出处:

Jeremy D. Keenan et al. Azithromycin to Reduce Childhood Mortality in Sub-Saharan Africa. N Engl J Med. April 26, 2018.

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    2018-04-28 hongbochen
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    2018-04-27 雅文博武

    学习了很多先进的医学知识

    0

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    2018-04-26 zdvfsadb

    学习了

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雅司病是在至少 14 个热带地区国家儿童慢性毁容性溃疡的根本病因。WHO 新采用的雅司病根除策略使用单轮阿奇霉素集体治疗,然后进行靶向治疗方案,来自试点研究的数据表明雅司病短期内显著减少。我们评估了 WHO 雅司病根除策略的长期效果

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由此可见,虽然大环内酯类药物的耐药性有所增加,但COPD GOLD D患者接受24-36个月LT-CC-A治疗,ECOPD和住院率持续下降超过50%,并且只伴有少量的不良事件。

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哮喘发作给全球疾病带来实质性的负担。未控制的持续性哮喘成年患者除了维持治疗外还需要额外的治疗。

警惕!阿奇霉素可引发致命性心律失常!

阿奇霉素是第二代大环内酯类抗生素,抗菌谱广,应用广泛,如小儿急性支气管炎、肺炎、沙眼、伤寒、疟疾、中耳炎、皮肤和软组织感染和社区获得性肺炎等等,具有高有效率和清除率特点。但是,随着阿奇霉素临床日趋广泛,其不良反应也日趋增多,其中部分不良反应甚至是致命的!

头孢菌素+阿奇霉素,究竟合不合理?

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