Department of Clinical Microbiology 9301, Rigshospitalet & ISIM, University of Copenhagen, Juliane Maries vej 22, DK-2100 Copenhagen, Denmark.
BMC Med. 2011 Apr 4;9:32. doi: 10.1186/1741-7015-9-32.
Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients is caused by biofilm-growing mucoid strains. Biofilms can be prevented by early aggressive antibiotic prophylaxis or therapy, and they can be treated by chronic suppressive therapy. New results from one small trial suggest that addition of oral ciprofloxacin to inhaled tobramycin may reduce lung inflammation. Clinical trials with new formulations of old antibiotics for inhalation therapy (aztreonam lysine) against chronic P. aeruginosa infection improved patient-reported outcome, lung function, time to acute exacerbations and sputum density of P. aeruginosa. Other drugs such as quinolones are currently under investigation for inhalation therapy. A trial of the use of anti-Pseudomonas antibiotics for long-term prophylaxis showed no effect in patients who were not already infected. Use of azithromycin to treat CF patients without P. aeruginosa infection did not improve lung function. Here I review the recent advances in the treatment of P. aeruginosa lung infections with a focus on inhalation treatments targeted at prophylaxis and chronic suppressive therapy.
囊性纤维化（CF）患者肺部的慢性铜绿假单胞菌感染是由生物膜生长的粘液型菌株引起的。早期积极的抗生素预防或治疗可以预防生物膜的形成，慢性抑制性治疗可以治疗生物膜。一项小型试验的新结果表明，口服环丙沙星联合吸入妥布霉素可能会减轻肺部炎症。针对慢性铜绿假单胞菌感染的旧抗生素新配方的临床试验改善了患者报告的结果、肺功能、急性加重时间和铜绿假单胞菌痰密度。其他药物，如喹诺酮类药物，目前正在研究用于吸入治疗。一项使用抗铜绿假单胞菌抗生素进行长期预防的试验表明，在尚未感染的患者中没有效果。使用阿奇霉素治疗没有铜绿假单胞菌感染的 CF 患者并未改善肺功能。在这里，我综述了铜绿假单胞菌肺部感染治疗方面的最新进展，重点是针对预防和慢性抑制性治疗的吸入治疗。
