Máiz Carro Luis, Cantón Moreno Rafael
Unidad de Fibrosis Quística, Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain.
Med Clin (Barc). 2004 Mar 6;122(8):311-6. doi: 10.1016/s0025-7753(04)74217-7.
Progressive lung disease, caused by chronic endobronchial colonization, is the major cause of morbidity and mortality in patients with cystic fibrosis (CF). Several pathogens, including Staphylococcus aureus and Pseudomonas aeruginosa are responsible for this effect. The steadily improving prognosis of CF has been attributed to the use of antibiotics with activity against these organisms. Despite a significant increase in the amount of published material demonstrating the potential role of macrolide antibiotics as antiinflammatory agents and their effects on bacterial virulence, their mechanism of action in CF patients is still unknown. Although there is a limited number of clinical trials assessing the efficacy and safety of azithromycin (AZM) in CF, increasing evidence suggests that 3 to 6-month AZM treatment in CF patients is safe and well tolerated. This treatment results in clinical improvement, decreasing the number of pulmonary exacerbations and increasing pulmonary function. Therefore, chronic treatment with AZM should be considered in CF patients added to conventional therapy. Clinical experience with macrolides other than AZM in CF patients is very limited.
由慢性支气管内定植引起的进行性肺部疾病是囊性纤维化（CF）患者发病和死亡的主要原因。包括金黄色葡萄球菌和铜绿假单胞菌在内的几种病原体导致了这种情况。CF预后的稳步改善归因于使用了对这些病原体有活性的抗生素。尽管大量已发表的材料表明大环内酯类抗生素作为抗炎剂的潜在作用及其对细菌毒力的影响，但它们在CF患者中的作用机制仍然未知。虽然评估阿奇霉素（AZM）在CF中的疗效和安全性的临床试验数量有限，但越来越多的证据表明，CF患者接受3至6个月的AZM治疗是安全且耐受性良好的。这种治疗可带来临床改善，减少肺部急性加重次数并提高肺功能。因此，对于CF患者，应考虑在常规治疗基础上加用AZM进行长期治疗。CF患者使用除AZM以外的大环内酯类药物的临床经验非常有限。
