Thorn Shannon T, Brown Mark A, Yanes James J, Sherrill Duane L, Pugmire Juliana, Anderson K Arbor, Klotz Stephen A
Department of Medicine, University of Arizona Health Sciences, Tucson, 85724, United States.
J Cyst Fibros. 2009 Sep;8(5):316-20. doi: 10.1016/j.jcf.2009.07.005. Epub 2009 Aug 15.
The treatment of Nocardia species found in the sputum of cystic fibrosis patients is of unknown value.
We conducted a retrospective analysis of the impact of directed oral antibiotic therapy against Nocardia spp. isolated from the sputum of 17 cystic fibrosis patients over a 10-year period. Pulmonary Function Tests were used as the clinical indicator of the disease state and the data were analyzed by general linear mixed model statistics with univariate analysis.
Pulmonary Function Test values of all patients studied showed no significant difference before, during, or after the antibiotic treatment period. Treatment groups did not differ from non-treatment groups. This held true for Forced Expiratory Volume over 1 s and Functional Vital Capacity analysis. In addition, individual patient analysis did not reveal any trends or outliers.
Oral antibiotic therapy of cystic fibrosis patients colonized with Nocardia does not appear to affect clinical outcome. This suggests that deferring therapy may be an acceptable alternative and justifies conducting a future placebo controlled trial. In addition, this study model may be useful in analyzing the effect of therapy on other rare and difficult organisms, such as fungi and mycobacteria in the cystic fibrosis population.
在囊性纤维化患者痰液中发现的诺卡氏菌属的治疗价值尚不清楚。
我们对10年间从17例囊性纤维化患者痰液中分离出的诺卡氏菌属进行针对性口服抗生素治疗的影响进行了回顾性分析。肺功能测试用作疾病状态的临床指标，并通过单变量分析的通用线性混合模型统计对数据进行分析。
所有研究患者的肺功能测试值在抗生素治疗期之前、期间或之后均无显著差异。治疗组与非治疗组无差异。这在1秒用力呼气量和功能肺活量分析中也是如此。此外，个体患者分析未发现任何趋势或异常值。
对诺卡氏菌定植的囊性纤维化患者进行口服抗生素治疗似乎不会影响临床结果。这表明推迟治疗可能是一种可接受的选择，并有理由进行未来的安慰剂对照试验。此外，该研究模型可能有助于分析治疗对其他罕见和难处理的微生物的影响，如囊性纤维化患者群体中的真菌和分枝杆菌。
