呼吸道感染在感染性疾病中占有重要地位，細(xì)菌性肺炎是呼吸道感染中的主要代表性疾病，最重要的治療措施是抗菌治療，用藥選擇及方法正確與否直接影響治療的成敗。同時(shí)如何降低醫(yī)療費(fèi)用也是臨床醫(yī)生需要考慮的棘手問題。據(jù)國外文獻(xiàn)報(bào)道在英國每年約有5億張以上的抗微生物藥物處方，其中住院處方中約40％為靜脈制劑，而我國住院靜脈制劑的處方比例則更高。醫(yī)療費(fèi)用的增加部分與靜脈用藥過多有關(guān)。為尋求解決臨床治療與醫(yī)療費(fèi)用之間的矛盾，選擇高效、低毒、廉價(jià)的抗菌藥物，1987年Quintiliani等[1]首先提出了抗生素序貫療法（sequential therapy）的概念，即在經(jīng)過相對(duì)短療程（48～72 h）靜脈抗菌藥物治療，臨床癥狀基本穩(wěn)定或改善后，改為口服抗菌藥物治療。口服的抗菌藥物可以是與前者完全相同的口服劑型，也可以是同一類或抗菌譜相似的同一級(jí)藥物，后也有人稱之為"轉(zhuǎn)換治療"（switch therapy）、"降級(jí)治療"（step-down therapy）。據(jù)國外文獻(xiàn)報(bào)道，住院的社區(qū)獲得性肺炎（CAP）應(yīng)用序貫療法者因早期出院每位患者節(jié)約費(fèi)用293~1393美元[2-4]。
引用本文： 劉勁,陳佰義. 呼吸道感染的序貫治療. 中國呼吸與危重監(jiān)護(hù)雜志, 2008, 08(1): 12-14. doi: 復(fù)制
| 1. | Quintiliani R，Cooper BW，Briceland LL，et al.Economic impact of streamlining antibiotic administration.Am J Med，1987，82：391-394. |
| 2. | Ramirez JA，Srinath L，Ahkee S，et al.Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.Arch Intern Med，1995，155：1273-1276. |
| 3. | Khan F，Karnik A.Clinical uses of sequential IV/PO ciprofloxacin vs ceftazidime in serious bacterial infections [abstract 139].Abstracts of the Ninth Mediterranean Congress on Chemother，Milan，Italy，1994. |
| 4. | Paladino JA，Sperry HE，Backes JM，et al.Clinical and economic evaluation of oral ciprofloxacin after an abbreviated course of intravenous antibiotics.Am J Med，1991，91：462-470. |
| 5. | Aujesky D，Auble TE，Yealy DM，et al.Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia.Am J Med，2005，118：384-392. |
| 6. | Ramirez JA，Srinath L，Ahkee S，et al.Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.Arch Intern Med，1995，155：1273-1276. |
| 7. | Ramirez JA.Switch therapy in community-acquired pneumonia.Diagn Microbiol Infect Dis，1995，22：219-223. |
| 8. | Kollef MH，Sherman G，Ward S，et al．Inadequate antimicrobial treatment of infections：a risk factor for hospital mortality among critically ill patients．Chest，1999，115：462-474. |
| 9. | Ibrahim EH，Sherman G，Ward S，et al．The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting.Chest，2000，118：146-155. |
| 10. | 賈東崗，雷招寶.抗生素的序貫療法及其研究進(jìn)展.藥物實(shí)踐雜志，2004，22：144-148. |
- 1. Quintiliani R，Cooper BW，Briceland LL，et al.Economic impact of streamlining antibiotic administration.Am J Med，1987，82：391-394.
- 2. Ramirez JA，Srinath L，Ahkee S，et al.Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.Arch Intern Med，1995，155：1273-1276.
- 3. Khan F，Karnik A.Clinical uses of sequential IV/PO ciprofloxacin vs ceftazidime in serious bacterial infections [abstract 139].Abstracts of the Ninth Mediterranean Congress on Chemother，Milan，Italy，1994.
- 4. Paladino JA，Sperry HE，Backes JM，et al.Clinical and economic evaluation of oral ciprofloxacin after an abbreviated course of intravenous antibiotics.Am J Med，1991，91：462-470.
- 5. Aujesky D，Auble TE，Yealy DM，et al.Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia.Am J Med，2005，118：384-392.
- 6. Ramirez JA，Srinath L，Ahkee S，et al.Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.Arch Intern Med，1995，155：1273-1276.
- 7. Ramirez JA.Switch therapy in community-acquired pneumonia.Diagn Microbiol Infect Dis，1995，22：219-223.
- 8. Kollef MH，Sherman G，Ward S，et al．Inadequate antimicrobial treatment of infections：a risk factor for hospital mortality among critically ill patients．Chest，1999，115：462-474.
- 9. Ibrahim EH，Sherman G，Ward S，et al．The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting.Chest，2000，118：146-155.
- 10. 賈東崗，雷招寶.抗生素的序貫療法及其研究進(jìn)展.藥物實(shí)踐雜志，2004，22：144-148.