Chua H L, Collis G G, Le Souëf P N
Dept of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia.
Eur Respir J. 1990 Nov;3(10):1114-6.
Nebulized antibiotics are being used increasingly in children with cystic fibrosis. We assessed the effect of nebulized antibiotic solutions of varying tonicity on lung function in 12 children aged 5-15 yrs with cystic fibrosis. Baseline forced expiratory volume in one second and (FEV1) was measured, followed by a single nebulization of normal saline (272 mosmol.kg-1), tobramycin (248 mosmol.kg-1), or ticarcillin (3,080 mosmol.kg-1). All children received each of these, administered randomly, one per day. FEV1 was remeasured 5, 15 and 30 min after completion of the nebulization. Ticarcillin (mean fall 10.7% (SD 8.9)) caused a larger fall in FEV1 than normal saline (4.8% (4.3), p less than 0.05). The fall in FEV1 for ticarcillin was greater than for tobramycin (1.2% (2.0), p less than 0.05). Normal saline did not result in a significantly larger fall in FEV1 than tobramycin (p greater than 0.05). Bronchoconstriction to ticarcillin persisted at 30 min. We conclude that nebulized antibiotics can affect lung function in children with cystic fibrosis if the solutions are hypertonic.
雾化抗生素在囊性纤维化患儿中的应用越来越广泛。我们评估了不同张力的雾化抗生素溶液对12名5至15岁囊性纤维化患儿肺功能的影响。测量了基线一秒用力呼气量（FEV1），随后分别对患儿进行一次生理盐水（272毫摩尔每千克）、妥布霉素（248毫摩尔每千克）或替卡西林（3080毫摩尔每千克）的雾化治疗。所有患儿均随机接受这三种药物的治疗，每天一种。在雾化完成后5分钟、15分钟和30分钟再次测量FEV1。替卡西林（平均下降10.7%（标准差8.9））导致的FEV1下降幅度大于生理盐水（4.8%（4.3），p<0.05）。替卡西林导致的FEV1下降幅度大于妥布霉素（1.2%（2.0），p<0.05）。生理盐水导致的FEV1下降幅度与妥布霉素相比无显著差异（p>0.05）。对替卡西林的支气管收缩在30分钟时仍持续存在。我们得出结论，如果溶液为高渗性，雾化抗生素会影响囊性纤维化患儿的肺功能。
