Author/Editor     Čižman, Milan
Title     Zdravljenje okužb v času povečane odpornosti pnevmokokov na antibiotike
Translated title     Treatment of infections during increased resistance of pneumococci to antibiotics
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 40, št. Suppl 2
Publication year     2001
Volume     str. 49-58
Language     slo
Abstract     Streptococcus pneumoniae is a common etiologic agent of acute otitis media, sinusitis, pneumonia, occult bacteriemia and meningitis. In the last decade, Streptococcus pneumoniae strains with a decreased susceptibility to penicillin, cephalosporins and other nonbeta-lactam antibiotics have been documented in several regions in the world, including Slovenia. Slovene data for 1999 indicate that invasive pneumococci were resistant to penicillin, trimethoprim/sulfamethoxazole, erythromycin, tetracycline and cefotaxime in percentages of 14.5%, 24.5%, 5.4%,10% and 2.7%, respectively. The choice of empirical antibiotic therapy is based on the local susceptibility of the common bacteria, as well as the pharmacoltinetic and pharmacodynamic properties, clinical efficacy, tolerance, side effects and cost of antibiotics and their effects on microbial ecology. In the article, the author reviews the empirical antibiotic treatment of common clinical syndromes caused by S. prieumoniae, as well as documented cases of therapy of infections caused by less sensitive strains of S. pneumoniae.
Summary     Streptococcus pneumoniae je pogost povzročitelj akutnega vnetja srednjega ušesa, akutnega vnetja obnosnih votlin, pljučnice, prikrite (okultne) bakteriemije in meningitisa. V zadnjem desetletju so pnevmokoki postali v številnih državah, vključno s Slovenijo, odporni na peniciline, cefalosporine in nekatere nebetalaktamske antibiotike. V Sloveniji je bilo v letu 1999 odpornih na penicilin, trimetoprim/sulfametoksazol, eritromicin, tetracikline in cefotaksim 14,5 %, 24,5 %, 5,4 %,10 % in 2,7 % invazivnih pnevmokokov. Pri izbiri antibiotikov moramo upoštevati poleg lokalne občutljivosti bakterij še farmakokinetiko in farmakodinamiko antibiotikov, klinično učinkovitost, prenašanje, stranske učinke, ceno in vpliv na ekologijo bakterij. V članku avtor podaja pregled izkustvenega zdravljenja pogostih kliničnih sindromov, ki jih povzročajo pnevmokoki, in odmerke antibiotikov za usmerjeno zdravljenje okužb, ki jih povzročajo manj odporni pnevmokoki.
Descriptors     PNEUMOCOCCAL INFECTIONS
STREPTOCOCCUS PNEUMONIAE
DRUG RESISTANCE, MICROBIAL
ANTIBIOTICS
OTITIS MEDIA
SYNOVITIS
PNEUMONIA, BACTERIAL