Matsen J M, Bosso J A
Department of Pathology, School of Medicine, University of Utah, Salt Lake City 84132.
Pediatr Infect Dis J. 1989 Sep;8(9 Suppl):S117-9; discussion S128-32. doi: 10.1097/00006454-198909001-00006.
Eradication of pulmonary infection by Pseudomonas aeruginosa in cystic fibrosis (CF) patients has long presented a significant challenge to the medical community. Many antimicrobial agents have proved incompletely effective against this persistent pathogen, and even the aminoglycosides, which represent the traditional therapy for such infections, have been associated with considerable toxicity and resistance. The monobactam antibacterial agent aztreonam is used both as single-agent therapy and in combination with other drugs. Several controlled, clinical trials have demonstrated the efficacy of aztreonam in the treatment of CF patients with pulmonary exacerbations caused by P. aeruginosa. The only side effect of aztreonam therapy commonly encountered in these studies was elevation of hepatic transaminase concentrations; this effect was of uncertain significance. It was concluded that aztreonam may offer clinical efficacy comparable to that provided by the combination of tobramycin plus azlocillin. Further, there does not seem to be any appreciable difference in the development of resistance to aztreonam compared with traditional therapies.
长期以来，根除囊性纤维化（CF）患者肺部的铜绿假单胞菌感染一直是医学界面临的重大挑战。许多抗菌药物已被证明对这种顽固的病原体疗效不完全，甚至作为此类感染传统治疗药物的氨基糖苷类药物，也存在相当大的毒性和耐药性问题。单环β-内酰胺类抗菌药物氨曲南既用于单药治疗，也与其他药物联合使用。多项对照临床试验已证明氨曲南在治疗由铜绿假单胞菌引起的CF肺部病情加重患者方面的疗效。这些研究中常见的氨曲南治疗唯一副作用是肝转氨酶浓度升高；这种影响的意义尚不确定。得出的结论是，氨曲南可能具有与妥布霉素加阿洛西林联合使用相当的临床疗效。此外，与传统疗法相比，对氨曲南产生耐药性的情况似乎没有明显差异。
