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題名 | Fluoroquinolone用於小兒之安全性=Fluoroquinolone--Safety in Pediatrics |
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作者 | 葉盈池; 劉人瑋; 王春玉; | 書刊名 | 藥學雜誌 |
卷期 | 29:1=114 2013.03[民102.03] |
頁次 | 頁56-60 |
分類號 | 418.281 |
關鍵詞 | 恩菎類抗生素; 藥品不良反應; 兒童; Fluoroquinolones; Adverse effect; Pediatric; |
語文 | 中文(Chinese) |
中文摘要 | 臨床執業傳統上並不建議兒童或新生兒使用 fluoroquinolone 類藥品,因為動物實驗中曾發現未成熟的狗使用這類藥品後造成軟骨異常與關節病變。根據美國食品藥品管理局 (FDA),fluoroquinolone 類藥品僅能用於複雜性泌尿道感染 (complicated urinary tract infection) 或腎盂腎炎 (pyelonephritis),或是感染吸入性炭疽病 (inhalation anthrax) 兒童。本文藉由系統性回顧文獻方式,希望探討這個臨床具有爭議的問題。經系統性查詢醫療文獻後,分別有兩篇系統性綜論探討 fluoroquinolone 類藥品使用於兒童或新生兒的療效與安全性。綜合醫學文獻中使用 fluoroquinolone 類藥品於兒童的報告,絕大多數用於複雜性泌尿道感染或腎盂腎炎,在大型世代研究中發現,使用 fluoroquinolone 類藥品的兒童,相較於其他抗生素,發生肌肉或骨骼不良反應風險並未顯著增加。另一方面,新生兒使用 fluoroquinolone 類藥品的研究顯示,大部分使用於敗血症且培養菌株已具有多重抗藥性,雖然並未發現顯著增加肌肉或骨骼不良反應,但數據仍相當有限。臨床上,兒童或新生兒仍應儘量避免使用 fluoroquinolone 類藥品,如需使用應綜合考量利益與風險並嚴密追蹤。 |
英文摘要 | Several animal studies showed fluoroquinolones may cause cartilage damage and arthropathy, therefore, this class of antimicrobials is not recommended for pediatrics or neonates with infection. Fluoroquinolones were approved for children with complicated urinary tract infection, pyelonephritis, anthrax by United State Food and Drug Administration (FDA). We aimed to resolve this controversial issue by comprehensive literature review. After systematic search of electronic medical databases, we identified two systematic reviews which met this clinical question, and discussed the efficacy and safety of fluoroquinolones in pediatrics or neonates. After reviewing these studies, most children were treated by ciprofloxacin for complicated urinary tract infection or pyelonephritis. In large cohort studies, children treated by fluoroquinolones, compared to other antibiotics, were not at significantly increased risk of musculoskeletal adverse effects. In studies including neonates, fluoroquinolones were exclusively administrated for the treatment of sepsis and culture proven septicemia due to multidrug-resistant organisms. Although no significant difference was observed among fluoroquinolones and control groups, the data were limited. In clinical practice, fluoroquinolones should be avoided, if used, benefit should outweigh harm and closely monitoring is recommended. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。