Wegmans School of Pharmacy at St. John Fisher College , Rochester, NY 14618 , USA.
Expert Opin Pharmacother. 2013 Oct;14(15):2115-24. doi: 10.1517/14656566.2013.831070. Epub 2013 Aug 31.
Chronic airway infection in cystic fibrosis (CF) is linked with progressive loss of pulmonary function and is the primary cause of mortality. Treatment regimens have generally focused on the use of chronic antibiotic therapy to target Pseudomonas aeruginosa (PA), a major pathogen associated with a decline in FEV1%. Specifically, inhaled antibiotic therapy provides high antibiotic sputum concentrations and decreases bacterial burden.
This article describes the pharmacology, pharmacodynamics/pharmacokinetics, clinical efficacy, microbiology and safety of aztreonam lysine (AZLI, Cayston), an inhaled antibiotic indicated for use in CF patients with PA. Articles were identified using MEDLINE (1966 - June 13, 2013) and EMBASE (1947 - June 13, 2013). Abstracts from the annual meeting (2011 - 2012) of the North American Cystic Fibrosis Conference were searched to identify additional publications.
AZLI is an additional product that can be used in the management of CF and will likely play a major role in the suppression of PA. Clinical trials have demonstrated improvements in pulmonary function and patient reported symptoms. AZLI may therefore be used as an alternative to traditional inhaled antibiotics in patients with moderate-to-severe CF and PA colonization. Further investigation is warranted into use of AZLI in mild lung disease and for PA eradication.
囊性纤维化（CF）慢性气道感染与肺功能进行性丧失有关，是导致死亡的主要原因。治疗方案通常侧重于使用慢性抗生素治疗来靶向铜绿假单胞菌（PA），PA 是与 FEV1%下降相关的主要病原体。具体而言，吸入抗生素疗法可提供高抗生素痰浓度并降低细菌负荷。
本文描述了用于 CF 患者治疗 PA 的吸入性抗生素 AZLI（Cayston，氨曲南赖氨酸）的药理学、药效学/药代动力学、临床疗效、微生物学和安全性。使用 MEDLINE（1966 年-2013 年 6 月 13 日）和 EMBASE（1947 年-2013 年 6 月 13 日）检索文章。搜索了北美囊性纤维化会议年会（2011-2012 年）的摘要，以确定其他出版物。
AZLI 是可用于 CF 管理的另一种产品，可能在抑制 PA 方面发挥重要作用。临床试验已经证明了肺功能和患者报告症状的改善。因此，AZLI 可作为中重度 CF 和 PA 定植患者的传统吸入性抗生素的替代物。需要进一步研究 AZLI 在轻度肺部疾病和 PA 根除中的应用。
