吸入抗生素治疗肺炎。
Inhaled antibiotics for the treatment of pneumonia.
机构信息
Section of Pulmonary, Critical Care, and Respiratory Services, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
出版信息
Curr Opin Pulm Med. 2019 May;25(3):289-293. doi: 10.1097/MCP.0000000000000557.
PURPOSE OF REVIEW
To describe recent developments in trials exploring inhaled antibiotics for treating severe pneumonia.
RECENT FINDINGS
Three recent randomized studies investigated the potential role for aerosolized antibiotics for gram-negative pneumonia in ventilated patients. One single center, nonblinded investigation suggested a benefit with inhaled amikacin for resistant gram-negative infections. However, two multicenter, blinded trials found no benefit to adjunctive nebulized amikacin for severe gram-negative pneumonia.
SUMMARY
Well done clinical trials do not support the routine use of inhaled amikacin for pneumonia in ventilated patients. There may be a potential role for aerosolized antibiotics when other options are limited.
目的综述
描述探索吸入性抗生素治疗重症肺炎的临床试验的最新进展。
最近的发现
三项最近的随机研究调查了雾化抗生素治疗呼吸机相关性革兰氏阴性肺炎的潜在作用。一项单中心、非盲研究提示吸入阿米卡星治疗耐药性革兰氏阴性感染有益。然而，两项多中心、盲法试验发现，附加使用雾化阿米卡星治疗重症革兰氏阴性肺炎无益。
总结
精心设计的临床试验不支持常规使用吸入性阿米卡星治疗呼吸机相关性肺炎。当其他治疗方案受到限制时，雾化抗生素可能有一定的作用。
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