[侵袭性脑膜炎球菌感染的抗生素治疗]。

La Revue du praticien Pub Date : 2024-10-01
Hervé Haas, Marion Caseris
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引用次数: 0

摘要

侵袭性脑膜炎球菌感染的抗生素治疗。侵袭性脑膜炎球菌感染(IMI)是极其严重的病症,需要尽早进行抗生素治疗,以减少并发症和死亡。可能会出现三种不同的情况:1)在院前环境中出现临床怀疑的暴发性紫癜;2)确诊或强烈怀疑 IMI;3)对患者的接触者进行接触后化学预防。在前两种情况下,第三代头孢菌素(C3G)、头孢噻肟(cefotaxime)或头孢曲松(ceftriaxone)是参考抗生素,其优点是对鼻咽部脑膜炎球菌携带有影响。接触者的化学预防以利福平为基础,但环丙沙星(视敏感性而定)和 C3Gs 也是可能的替代药物。
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[Antibiotic treatment of invasive meningococcal infections].

ANTIBIOTIC TREATMENT OF INVASIVE MENINGOCOCCAL INFECTION. Invasive meningococcal infections (IMI) are extremely severe pathologies that justify very early antibiotic therapy to limit complications and death. Three different situations may arise: 1) clinical suspicion of purpura fulminans in the pre-hospital setting, 2 confirmed or strongly suspected IMI, 3) post-exposure chemoprophylaxis of a patient's contacts. In the first two situations, 3rd generation cephalosporins (C3G), cefotaxime or ceftriaxone are the reference antibiotics, and have the advantage of having an impact on nasopharyngeal carriage of meningococcus. Chemoprophylaxis of contact subjects is based on rifampicin, but ciprofloxacin (subject to retained sensitivity) and C3Gs are possible alternatives.

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