Zabner R, Quinn J P
Infectious Disease Division, Humana-Michael Reese Hospital, Chicago, IL.
Semin Respir Infect. 1992 Sep;7(3):210-7.
We reviewed the current literature on the role of antibiotic therapy in cystic fibrosis, concentrating on studies directing therapy at Pseudomonas aeruginosa. To highlight controversial areas, we examined studies comparing monotherapy with combination therapy, home intravenous treatment versus hospital treatment, intravenous versus oral therapy, and the role of aerosolized antibiotics. We found that all systemic therapies with antipseudomonal activity were of comparable efficacy. Data on the efficacy of aerosolized treatment were equivocal. There is a substantial body of anecdotal literature addressing the issue of antibiotic resistance complicating treatment of cystic fibrosis. This will be briefly reviewed and the responsible mechanisms will be outlined. There is a secular trend for selection of more resistant pathogens in the lungs of CF patients. In the individual patient, however, emergence of antibiotic resistance may occur without deleterious clinical effects.
我们回顾了当前关于抗生素治疗在囊性纤维化中作用的文献，重点关注针对铜绿假单胞菌进行治疗的研究。为突出有争议的领域，我们审视了比较单一疗法与联合疗法、家庭静脉治疗与住院治疗、静脉治疗与口服治疗以及雾化抗生素作用的研究。我们发现，所有具有抗假单胞菌活性的全身疗法疗效相当。雾化治疗疗效的数据并不明确。有大量轶事性文献涉及囊性纤维化治疗中抗生素耐药性这一复杂问题。本文将对此进行简要回顾并概述相关作用机制。在囊性纤维化患者肺部，选择更具耐药性病原体存在长期趋势。然而，在个体患者中，抗生素耐药性的出现可能并无有害的临床影响。
