護理師照護一位發燒且有生產性咳嗽的病人，痰液培養結果顯示肺炎鏈球菌，但病人對盤尼西林過敏。下列何類抗生素是較適合的替代選擇？
A nurse is managing a client with a fever and productive cough. Sputum culture results show Streptococcus pneumoniae. The client has a penicillin allergy. Which antibiotic class is the most appropriate alternative?
- ABeta-lactamase inhibitors (e.g., clavulanate)β-內醯胺酶抑制劑（例如：克拉維酸）
- BFluoroquinolones (e.g., levofloxacin)氟喹諾酮類（例如：左氧氟沙星）
- CMacrolides (e.g., azithromycin)✓ 正解大環內酯類（例如：阿奇黴素）
- DAminoglycosides (e.g., gentamicin)胺基糖苷類（例如：慶大黴素）
肺炎鏈球菌是社區型肺炎常見致病菌。若病人對盤尼西林（β-內醯胺類）過敏，大環內酯類（Macrolides，如 azithromycin）是治療的常用替代藥物。胺基糖苷類（Aminoglycosides）對呼吸道感染效果較差，氟喹諾酮類（Fluoroquinolones）通常為二線選擇，β-內醯胺酶抑制劑需與 β-內醯胺類合併使用。
Streptococcus pneumoniae is a common cause of community-acquired pneumonia. For penicillin-allergic clients (beta-lactam allergy), macrolides (e.g., azithromycin) are common alternatives. Aminoglycosides are not effective for typical respiratory pathogens; fluoroquinolones are usually reserved as second-line agents; beta-lactamase inhibitors must be combined with beta-lactams, which are contraindicated here.
美國的傳染病學家或藥師經常參與抗生素選擇的決策；台灣的醫師在臨床上會依據經驗與藥物敏感性報告來選擇，藥師的諮詢角色也日益重要。