Maselli Diego J, Keyt Holly, Restrepo Marcos I
Division of Pulmonary Diseases & Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229, USA.
University of Texas Health at San Antonio, San Antonio, TX 78240, USA.
Int J Mol Sci. 2017 May 16;18(5):1062. doi: 10.3390/ijms18051062.
The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF) and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include , Methicillin-resistant , species and non-tuberculous (NTM). These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics. Subsequent research advances focused on the development of antibiotic agents able to achieve high tissue concentrations capable of reducing the bacterial load of difficult-to-treat organisms in hosts with chronic respiratory conditions. In this review, we focus on the evidence regarding the use of antibiotic therapies administered through the respiratory system via inhalation, nebulization or aerosolization, specifically in patients with chronic respiratory diseases that include CF, non-CF bronchiectasis and NTM. However, further research is required to address the potential benefits, mechanisms of action and applications of inhaled antibiotics for the management of difficult-to-treat infections in patients with chronic respiratory diseases.
在临床实践中，对受难治性感染影响的慢性呼吸道疾病患者的管理已成为一项挑战。诸如囊性纤维化（CF）和非CF支气管扩张等病症需要广泛的治疗策略来应对耐多药病原体，这些病原体包括耐甲氧西林金黄色葡萄球菌、铜绿假单胞菌和非结核分枝杆菌（NTM）。这些挑战促使科学家通过使用吸入、雾化或喷雾抗生素经肺部系统递送抗菌剂。随后的研究进展集中在开发能够达到高组织浓度的抗生素，以降低患有慢性呼吸道疾病宿主中难治性生物体的细菌载量。在本综述中，我们重点关注通过吸入、雾化或喷雾经呼吸系统给予抗生素治疗的证据，特别是在患有CF、非CF支气管扩张和NTM等慢性呼吸道疾病的患者中。然而，需要进一步研究以探讨吸入性抗生素在管理慢性呼吸道疾病患者难治性感染方面的潜在益处、作用机制和应用。
