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评估吸入用阿米卡星作为静脉联合治疗(头孢他啶和阿米卡星)辅助治疗小儿囊性纤维化肺部加重期的疗效。

Evaluating the efficacy of inhaled amikacin as an adjunct to intravenous combination therapy (ceftazidime and amikacin) in pediatric cystic fibrosis pulmonary exacerbation.

作者信息

Rakhshan Amin, Farahbakhsh Nazanin, Khanbabaee Ghamartaj, Tabatabaii Seyed Ahmad, Sadr Saeed, Hassanzad Maryam, Sistanizad Mohammad, Dastan Farzaneh, Hajipour Mahmoud, Bahadori Amir Reza, Mirrahimi Bahador

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Pediatric Pulmonology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Front Pharmacol. 2023 Mar 9;14:1130374. doi: 10.3389/fphar.2023.1130374. eCollection 2023.

Abstract

is the most common microorganism found in the sputum culture of Cystic fibrosis (CF) patients causing the pulmonary destruction. Aminoglycosides have a low diffuse rate from lipid membranes, and respiratory system secretions. Regarding the burden of pulmonary exacerbation caused by the in cystic fibrosis patients in the long term and the limited number of clinical trials focused on appropriate treatment strategies, the present study evaluated the concurrent inhaled and intravenous aminoglycoside antibiotics for pulmonary exacerbation caused by the as a safe and effective treatment in children. This study was a blinded, randomized clinical trial phase conducted in a tertiary referral pediatric teaching hospital from May 2021 to May 2022. The patients were randomly allocated to receive intravenously administered ceftazidime and Amikacin alone or with inhaled Amikacin. Forced expiratory volume (FEV1), Amikacin the level, kidney function tests, audiometry, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), hospital stay, and bacterial eradication rate were compared in two therapy groups. the average FEV has increased by 47% in Neb + group compared to Neb- group following treatment. Hospital stay was lower in Neb + group. No renal toxicity or ototoxicity was observed in both therapy groups. eradication rate Neb- and Neb + groups were 44% and 69%, respectively (-value = 0.15). Concurrent inhaled and intravenous Amikacin is safe and effective to treat exacerbation in CF patients. Moreover, co-delivery antibiotics' route treatment increased the eradication rate. Although not statistically significant, never the less, it is clinically relevant. The intervention reduced the length of hospitalization in this group. clinicaltrials.gov, identifier [IRCT20120415009475N10].

摘要

是囊性纤维化(CF)患者痰液培养中发现的导致肺部破坏的最常见微生物。氨基糖苷类药物从脂质膜和呼吸系统分泌物中的扩散率较低。鉴于长期以来囊性纤维化患者肺部加重的负担以及专注于适当治疗策略的临床试验数量有限,本研究评估了同时吸入和静脉注射氨基糖苷类抗生素治疗由该微生物引起的肺部加重在儿童中作为一种安全有效的治疗方法。 本研究是一项于2021年5月至2022年5月在一家三级转诊儿科教学医院进行的双盲、随机临床试验阶段。患者被随机分配接受单独静脉注射头孢他啶和阿米卡星或联合吸入阿米卡星。比较了两个治疗组的用力呼气量(FEV1)、阿米卡星水平、肾功能测试、听力测定、炎症标志物(红细胞沉降率和C反应蛋白)、住院时间和细菌根除率。治疗后,与Neb-组相比,Neb +组的平均FEV增加了47%。Neb +组的住院时间更短。两个治疗组均未观察到肾毒性或耳毒性。Neb-组和Neb +组的根除率分别为44%和69%(P值 = 0.15)。同时吸入和静脉注射阿米卡星治疗CF患者的肺部加重是安全有效的。此外,联合给药抗生素的途径治疗提高了根除率。虽然在统计学上不显著,但在临床上是相关的。该干预缩短了该组的住院时间。 临床试验.gov,标识符[IRCT20120415009475N10] 。

需要注意的是,原文中部分关键微生物名称缺失,以上译文是基于完整语义逻辑补全推测后的翻译。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4e/10034196/27b40d16645d/fphar-14-1130374-g001.jpg

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