Knechtel Stephanie A, Klepser Michael E
Ferris State University, 1000 Oliver Street, Spindler Hall, Kalamazoo, Michigan, USA.
Expert Opin Drug Saf. 2007 Sep;6(5):523-32. doi: 10.1517/14740338.6.5.523.
Aerosolized delivery of a number of antimicrobial agents has been studied. Despite a theoretical soundness behind this strategy, full consideration of the potential toxicities associated with this mode of administration is imperative. Aerosolized amphotericin B, as both deoxycholate and lipid formulations, has been studied in a variety of high-risk patient populations for prophylaxis and treatment against fungal infections. Although available data remain inconclusive regarding the clinical efficacy of this therapy, variability among results may be due to lack of standardization of administration methods and doses. Akin to the lack of clinical consensus, data regarding the tolerability of this means of amphotericin B delivery are conflicting. This variability may again be accounted for by the lack of standardized means for aerosolized administration. Owing to uncertain clinical benefit and concern for pulmonary toxicities, the use of aerosolized amphotericin B should be limited to clinical investigations at this time.
已经对多种抗菌剂的雾化给药进行了研究。尽管该策略背后有理论依据,但必须充分考虑与这种给药方式相关的潜在毒性。雾化两性霉素B,包括脱氧胆酸盐和脂质制剂,已在各种高危患者群体中进行研究,用于预防和治疗真菌感染。尽管现有数据关于这种治疗的临床疗效仍无定论,但结果的差异可能是由于给药方法和剂量缺乏标准化。与缺乏临床共识类似,关于这种两性霉素B给药方式耐受性的数据也相互矛盾。这种差异可能再次归因于雾化给药缺乏标准化方法。由于临床益处不确定且担心肺部毒性,目前雾化两性霉素B的使用应仅限于临床研究。