NEJM:非洲阿奇霉素分发项目与抗生素耐药风险

2020-11-12 MedSci原创 MedSci原创

阿奇霉素每年2次,为期4年的分发试验中,接受阿奇霉素地区的大环内酯类耐药性显著高于接受安慰剂的地区,同时也导致非大环内酯类耐药风险增加

为期2年的研究证实,在撒哈拉以南非洲,对学龄前儿童每年进行2次阿奇霉素分发可降低儿童死亡率,但大环内酯类耐药性难以避免。近日研究人员考察了每年两次长期使用阿奇霉素对肠道菌群耐药基因的影响。
 
MORDOR试验在尼日尔地区开展,研究人员调查了4年来参与阿奇霉素分发研究儿童的肠道菌耐药性。总计30个村庄,年龄在1至59个月儿童参与,随机接受阿奇霉素或安慰剂,每6个月发放一次,共4年。在基线、36个月和48个月收集直肠拭子,以分析受试者的肠道菌耐药性。研究的主要结果是48个月时阿奇霉素组大环内酯类耐药率。
 
在整个48个月期间,安慰剂组和阿奇霉素组的平均覆盖率分别为86.6%和83.2%,共收集了3232份样本。阿奇霉素组大环内酯类抗生素耐药基因出现频率高于安慰剂组:36个月时是7.4倍,48个月时是7.5倍。阿奇霉素的持续大量使用也是非大环内酯类耐药的决定因素,包括对β-内酰胺类抗生素的耐药性。
 
在非洲,阿奇霉素每年2次,为期4年的分发试验中,接受阿奇霉素地区的大环内酯类耐药性显著高于接受安慰剂的地区,同时也导致非大环内酯类耐药风险增加。
 
原始出处:
 
Thuy Doan et al. Macrolide and Nonmacrolide Resistance with Mass Azithromycin Distribution. N Engl J Med, November 12, 2020.

 

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    2020-11-13 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2020-11-13 sy33345

    耐药菌不容忽视

    0

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    2020-11-13 13c30453m58暂无昵称

    学习学习学习

    0

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    2020-11-12 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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Lancet Rheumato:羟氯喹治疗类风湿性关节炎安全性研究

研究发现,类风湿性关节炎患者短期使用羟氯喹不会增加不良事件风险,但长期使用导致心血管死亡风险增加,即使短期联合使用羟氯喹和阿奇霉素也会导致患者心衰及心血管死亡风险增加

Circulation:羟氯喹和阿奇霉素心律失常风险高!世卫组织分析

近日一项发表在Circulation杂志的研究表示,这非常不靠谱,两药本身会增加心律失常风险,而组合起来更是“要命”。

警惕!阿奇霉素可引发心律失常,严重者会致命!

随着其他大环内酯类抗生素被陆续报道能产生心脏不良反应,阿奇霉素一度被认为是最安全的大环内酯类抗生素,因为其对心脏电位活动的影响最小,在有效剂量范围内几乎不产生明显的心血管不良反应。

JAMA Intern Med:克拉霉素增加DOAC高龄人群的出血风险

对于正在服用直接口服抗凝剂的高龄老年患者,与阿奇霉素相比,联合使用克拉霉素增加30天内大出血住院风险。

NATURE: 背靠背发文:羟氯喹和阿奇霉素连用无法对抗新冠

与对照相比,无论是HCQ还是HCQ+AZTH连用,对任何一个测试区间的病毒载量水平都没有显著影响。

Nat Med:老年患者应用羟氯喹和阿奇霉素治疗新冠肺炎,11%出现QT间期延长(附事件始末)

2月4日,Cell Research发表武汉病毒所等文章表明,在体外研究中,氯喹能有效抑制新冠病毒,详细报道:Cell Res:瑞德西韦和磷酸氯喹能在体外有效抑制新型冠状病毒(2019-nCoV)),