Smaldone G C, Palmer L B
Department of Medicine, State University of New York at Stony Brook, 11794-8172, USA.
Respir Care. 2000 Jun;45(6):667-75.
Aerosolized antibiotic therapy appears to have potential for targeted therapy to the airways and deep lung to prevent VAP in patients at high risk for this disease. The definition of that high-risk population is important if this model is to be successful. We are attempting to define susceptible patients by measuring the volume of airway secretions, which mirrors the inflammation milieu of the central airways. Elevated sputum volume is marked by heavy growth of pathogenic organisms and high levels of inflammatory cytokines. Large-scale clinical trials are necessary to define the usefulness of these surrogates in defining a targeted population and for assessing the potential of aerosolized antibiotic prophylactic therapy for preventing pneumonia and mortality. If successful, the aerosol approach may avoid systemic therapy and its associated complications.
雾化抗生素治疗似乎有针对气道和深部肺组织进行靶向治疗的潜力，以预防高危患者发生呼吸机相关性肺炎（VAP）。如果该模式要取得成功，明确高危人群的定义很重要。我们正试图通过测量气道分泌物量来确定易感患者，气道分泌物量反映了中央气道的炎症环境。痰液量增加表现为致病微生物大量生长和炎症细胞因子水平升高。需要进行大规模临床试验来确定这些替代指标在定义目标人群以及评估雾化抗生素预防性治疗预防肺炎和降低死亡率潜力方面的实用性。如果成功，雾化方法可能避免全身治疗及其相关并发症。
