Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2022 Jul 20;47(2):56-59.
Post-bronchoscopy pneumonia can affect the prognosis of lung cancer patients. This prospective study examined the efficacy of prophylactic antibiotics for lung cancer patients at high-risk of post-bronchoscopy pneumonia, determined by our prediction score, using three risk factors: age 70 years or older, current smoking, and central tumors visualized on CT.
Patients with lung cancer who underwent diagnostic bronchoscopy between June 2018 and March 2020 with a score of 2 points or higher were enrolled. Sulbactam/ampicillin was administered intravenously within one hour prior to bronchoscopy, followed by oral clavulanate/amoxicillin for three days. We used the data of lung cancer patients who underwent diagnostic bronchoscopy between April 2012 and July 2014 and exhibited a score of 2 or higher as the historical control.
Post-bronchoscopy pneumonia occurred in none of the 24 patients in the prophylaxis group and in 17 of 144 patients in the control group, with no significant difference in the incidence of pneumonia between the two groups.
Antibiotic prophylaxis can be effective and safe for the patients high-risk of post-bronchoscopy pneumonia. A multicenter prospective study to examine the effects of prophylactic antibiotics in high-risk patients is feasible with a modest number of participants.
支气管镜检查后肺炎会影响肺癌患者的预后。本前瞻性研究通过我们的预测评分，使用年龄≥ 70 岁、当前吸烟和 CT 上可见中央型肿瘤这三个危险因素，评估了预防性抗生素对肺癌高风险支气管镜检查后肺炎患者的疗效。
2018 年 6 月至 2020 年 3 月间，我们对评分≥ 2 分的肺癌患者进行诊断性支气管镜检查，术前 1 小时内静脉给予舒巴坦/氨苄西林，然后口服克拉维酸/阿莫西林 3 天。我们将 2012 年 4 月至 2014 年 7 月间评分≥ 2 分且接受诊断性支气管镜检查的肺癌患者的数据作为历史对照。
预防组的 24 例患者中无一例发生支气管镜检查后肺炎，而对照组的 144 例患者中有 17 例发生肺炎，两组肺炎发生率无显著差异。
对于高危支气管镜检查后肺炎的患者，抗生素预防治疗可能是有效且安全的。对于高危患者，使用适度数量的参与者进行预防性抗生素的多中心前瞻性研究是可行的。
