Martínez-García Miguel Ángel, Oscullo Grace, Barreiro Esther, Cuenca Selene, Cervera Angela, Padilla-Galo Alicia, de la Rosa David, Navarro Annie, Giron Rosa, Carbonero Francisco, Castro Otero Maria, Casas Francisco
Pneumology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain.
Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain.
J Clin Med. 2020 Jul 21;9(7):2317. doi: 10.3390/jcm9072317.
Nebulised antibiotics are habitually used in patients with bronchiectasis, but the use of dry powder inhaled antibiotics (DPIA) in these patients is extremely limited. This study seeks to analyse the efficacy and safety of DPIA in bronchiectasis patients.
Multi-centre study of historic cohorts. All the hospital centres in Spain were contacted in order to collect data on patients with a diagnosis of bronchiectasis who had taken at least one dose of DPIA. Its efficacy was analysed in clinical, functional and microbiological terms by comparing the year before and the year after the prescription of DPIA. Adverse effects and variables associated with these effects, or any need to withdraw the drug, were also analysed.
164 patients from 33 Spanish centres were included; 86% and 14% of these were treated with dry powder colistin and tobramycin, respectively. Chronic bronchial infection by was present in 86% of these patients, and DPIA significantly reduced the number of exacerbations, the quantity and purulence of sputum and the isolation of pathogenic microorganisms. The most common adverse effect was cough (40%), particularly in cases of Chronic Obstructive Pulmonary Disease (COPD) and a previous cough and in those patients who had difficulties in handling the device. These factors were associated with a higher level of withdrawal of the treatment. There were no serious adverse effects.
Our study suggests that DPIA are clinically efficacious and safe for treating bronchiectasis patients. Cough was shown to be the most common side-effect and reason for withdrawal of the treatment.
雾化抗生素常用于支气管扩张症患者，但干粉吸入抗生素（DPIA）在这些患者中的使用极为有限。本研究旨在分析DPIA在支气管扩张症患者中的疗效和安全性。
对历史队列进行多中心研究。联系了西班牙所有医院中心，以收集诊断为支气管扩张症且至少服用过一剂DPIA的患者的数据。通过比较开具DPIA处方前后一年的情况，从临床、功能和微生物学方面分析其疗效。还分析了不良反应以及与这些反应相关的变量，或是否需要停药。
纳入了来自西班牙33个中心的164例患者；其中86%和14%的患者分别接受了干粉多粘菌素和妥布霉素治疗。这些患者中86%存在慢性支气管感染，DPIA显著减少了病情加重次数、痰液量和脓性以及致病微生物的分离。最常见的不良反应是咳嗽（40%），尤其是慢性阻塞性肺疾病（COPD）患者、既往有咳嗽的患者以及操作设备有困难的患者。这些因素与较高的停药率相关。未出现严重不良反应。
我们的研究表明，DPIA在治疗支气管扩张症患者方面临床有效且安全。咳嗽是最常见的副作用和停药原因。
