Blumer J L, Stern R C, Yamashita T S, Myers C M, Reed M D
J Pediatr. 1986 May;108(5 Pt 2):854-60. doi: 10.1016/s0022-3476(86)80757-0.
Cephalosporins modified at the C-3 and C-7 positions of the cephem-nucleus have high antimicrobial activity and are safe. With evolution through first, second, and third generations, they have gained increasing gram-negative activity, but often at the expense of potency against gram-positive organisms. All third-generation cephalosporins have some intrinsic anti-Pseudomonas activity, indicating their potential benefit in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis. Rational therapy in this clinical setting requires recognition of the pharmacodynamic and pharmacokinetic idiosyncrasies intrinsic to this patient population. When these priorities are recognized, only two of the available agents, cefsulodin and ceftazidime, appear to be of any therapeutic value. Both agents have been evaluated extensively in the treatment of acute pulmonary exacerbation in cystic fibrosis, and both have been found to be safe and effective.
在头孢烯核的C-3和C-7位进行修饰的头孢菌素具有高抗菌活性且安全。随着第一代、第二代和第三代的发展，它们对革兰氏阴性菌的活性不断增强，但往往是以牺牲对革兰氏阳性菌的效力为代价。所有第三代头孢菌素都具有一定的内在抗假单胞菌活性，这表明它们在治疗囊性纤维化患者的急性肺部加重方面具有潜在益处。在这种临床情况下进行合理治疗需要认识到该患者群体固有的药效学和药代动力学特性。当认识到这些要点时，现有的药物中似乎只有头孢磺啶和头孢他啶具有任何治疗价值。这两种药物在治疗囊性纤维化急性肺部加重方面都经过了广泛评估，并且都被发现是安全有效的。
