Shinn等在偶然发现了灭滴灵治疗急性、溃疡性齿龈炎显著疗效后,才认识到灭滴灵是治疗厌氧菌的特效药物。目前,灭滴灵仍然是治疗厌氧菌败血症的广谱药物。在呼吸道感染方面,脆弱类杆菌很少参与,治疗这种厌氧菌感染,早期治疗药物是选择青霉素。此时,脆弱类菌群对抗生素治疗起着“决定性因素”,因为它们是产生β-内酰胺酶唯一常见的厌氧菌。因为,所有常见的呼吸道病原菌(肺炎链球菌、嗜血流感杆菌、卡他布兰汉球菌、百日咳杆菌)均对β-内酰胺抗生素敏感,因此,大环内酯类药物有取代青霉素的趋势,且它对于需氧菌和厌氧菌都有效。它的短处在于一方面由于口咽部和呼吸道感染时梭形杆菌不是少见的病原菌,且在试管内对大环内酯耐药。一些最重要的下呼吸道病原如军团肺炎杆菌、沙眼衣原体、肺炎支原体,对大环内酯药敏感而对青霉素耐药。Brook描述过青霉素常不能根除复发性咽扁桃体病人咽部的A组溶血性链球菌,有证据提示这是由于需氧菌和厌氧菌溶都是产生β-内酰胺酶的微 Shinn et al. Discovered metronidazole as an effective drug for the treatment of anaerobic bacteria after accidentally discovering the remarkable effect of metronidazole in treating acute and ulcerative gingivitis. At present, metronidazole is still a broad spectrum drug for the treatment of anaerobic sepsis. In respiratory tract infection, Bacteroides fragilis rarely participate in the treatment of this anaerobic infection, early treatment is the choice of penicillin. At this point, the fragile group of bacteria plays a “decisive factor” in antibiotic treatment because they are the only anaerobic bacteria that produce beta-lactamase. Because all common respiratory pathogens (S. pneumoniae, H. influenzae, B. catarrhalis, B. pertussis) are all sensitive to beta-lactam antibiotics, macrolides tend to replace penicillins , And it is effective for aerobic and anaerobic bacteria. Its weakness lies in the fact that Fusobacterium is not a rare pathogen on the one hand due to oropharyngeal and respiratory infections and is resistant to macrolides in vitro. Some of the most important lower respiratory tract pathogens such as Legionella pneumophila, Chlamydia trachomatis, Mycoplasma pneumoniae are susceptible to macrolide and resistant to penicillin. Brook describes penicillin often can not eradicate Group A hemolytic streptococcus in patients with recurrent pharyngeal tonsils, there is evidence that this is due to aerobic and anaerobic bacteria are produced micro-β-lactamase micro