加入我的最愛   診所位置    聯絡我們    語系:EN
正明診所
內科.血液科.腫瘤內科
專業的健康檢查
慢性病的預防與治療
癌症重症的預防與治療
 

特別的畫相

 

高血脂症、高血壓性心臟病併發中風

 

治癒原本需外科手術治療的心臟瓣膜疾病(病例1)

 
 
張國華整形外科
 
五星級的素食餐廳 - 長春素食
 
正明診所專業儀器
檢驗快速  報告正確
解說詳細  專業治療
 
首頁 > 文章分享 > 內文
 
 
 
咳嗽服抗生素對成人無療效有害 2012-12-20 1106
 
 

咳嗽服抗生素對成人無療效有害

作者: 【記者蘇湘雲/綜合外電報導】 | 台灣新生報 – 2012年12月20日 上午12:26

並非一有咳嗽症狀,就得馬上服用抗生素。瑞士一項最新研究指出,抗生素對多數成人咳嗽症狀沒有治療效果,除非出現肺炎症狀,否則不需要使用到抗生素,如果沒有肺炎跡象卻貿然使用萬博黴素等抗生素,不但沒有好處,反而會對身體造成傷害。

醫師常為咳嗽、支氣管炎患者開抗生素藥物,不過有些研究質疑這種做法沒什麼效果。瑞士研究人員以兩千多名成人咳嗽患者為研究對象,將這些人分成兩組,一組服用抗生素萬博黴素,另一組則使用安慰劑。

參與研究的民眾年齡都在十八歲以上,都有急性咳嗽症狀,症狀都沒有持續超過一個月,且也都沒有肺炎跡象。研究人員讓他們一天服用三次藥物,連續服用七天,研究人員發現,與使用安慰劑的患者相比,使用抗生素的患者復原狀況並沒有比較好,不但如此,患者更容易出現噁心、紅疹、腹瀉等藥物副作用。

研究指出,抗生素緩減咳嗽症狀、縮短生病時間的效果沒有比安慰劑來得好,代表抗生素無法有效減緩咳嗽症狀,也無法縮短病程。這項研究已於昨日發表於「刺胳針感染症」期刊。

研究人員菲利浦‧薛茲醫師強調,亂用抗生素可能造成嚴重腹瀉等副作用,也容易讓細菌產生多重抗藥性。

以上文章來自:http://news.msn.com.tw/news2957453.aspx

Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial

Prof Paul Little FRCGP a  , Beth Stuart PhD a, Michael Moore FRCGP a, Prof Samuel Coenen DMSc b, Prof Christopher C ButlerFRCGP d, Prof Maciek Godycki-Cwirko PhD f, Prof Artur Mierzecki PhD g, Slawomir Chlabicz PhD h, Prof Antoni Torres PhD i j, Jordi Almirall MD k l, Mel Davies MSc m, Tom Schaberg PhD n, Prof Sigvard Mölstad PhD o p, Prof Francesco Blasi MD q, An De SutterPhD r, Prof Janko Kersnik PhD s, Helena Hupkova PhD t, Pia Touboul MD u, Prof Kerenza Hood PhD e, Mark Mullee MSc a, Gilly O'Reilly PhD a, Curt Brugman MSc v, Prof Herman Goossens PhD c, Prof Theo Verheij PhD v, on behalf of the GRACE consortium

Summary

Background
Lower-respiratory-tract infection is one of the most common acute illnesses managed in primary care. Few placebo-controlled studies of antibiotics have been done, and overall effectiveness (particularly in subgroups such as older people) is debated. We aimed to compare the benefits and harms of amoxicillin for acute lower-respiratory-tract infection with those of placebo both overall and in patients aged 60 years or older.

Methods
Patients older than 18 years with acute lower-respiratory-tract infections (cough of ≤28 days' duration) in whom pneumonia was not suspected were randomly assigned (1:1) to either amoxicillin (1 g three times daily for 7 days) or placebo by computer-generated random numbers. Our primary outcome was duration of symptoms rated “moderately bad” or worse. Secondary outcomes were symptom severity in days 2—4 and new or worsening symptoms. Investigators and patients were masked to treatment allocation. This trial is registered with EudraCT (2007-001586-15), UKCRN Portfolio (ID 4175), ISRCTN (52261229), and FWO (G.0274.08N).

Findings
1038 patients were assigned to the amoxicillin group and 1023 to the placebo group. Neither duration of symptoms rated “moderately bad” or worse (hazard ratio 1·06, 95% CI 0·96—1·18; p=0·229) nor mean symptom severity (1·69 with placebo vs 1·62 with amoxicillin; difference −0·07 [95% CI −0·15 to 0·007]; p=0·074) differed significantly between groups. New or worsening symptoms were significantly less common in the amoxicillin group than in the placebo group (162 [15·9%] of 1021 patients vs 194 [19·3%] of 1006; p=0·043; number needed to treat 30). Cases of nausea, rash, or diarrhoea were significantly more common in the amoxicillin group than in the placebo group (number needed to harm 21, 95% CI 11—174; p=0·025), and one case of anaphylaxis was noted with amoxicillin. Two patients in the placebo group and one in the amoxicillin group needed to be admitted to hospital; no study-related deaths were noted. We noted no evidence of selective benefit in patients aged 60 years or older (n=595).

Interpretation
When pneumonia is not suspected clinically, amoxicillin provides little benefit for acute lower-respiratory-tract infection in primary care both overall and in patients aged 60 years or more, and causes slight harms.

Funding
European Commission Framework Programme 6, UK National Institute for Health Research, Barcelona Ciberde Enfermedades Respiratorias, and Research Foundation Flanders.

以上研究的全文:http://press.thelancet.com/LRTI.pdf 

 

god moginrv04-1.JPG
 
回上一頁
 
 
關於我們  |  服務項目  |  環境設施  |  案例分享  |  生活醫學  |  回首頁  |  TOP 自費診所無健保
正明診所 版權所有 © 2012 All Rights Reserved. 地址:台北市四維路76巷9號 預約專線:02-2325-9210  02-2325-9211
最佳解析度1024*768 若觀看不到動畫,請下載 Flash player 網頁設計TNN