Kelly H W, Lovato C
Drug Intell Clin Pharm. 1984 Oct;18(10):772-83. doi: 10.1177/106002808401801001.
Chronic pulmonary infections contribute significantly to the morbidity and mortality of patients with CF. The primary pathogens are Pseudomonas aeruginosa (PA) and Staphylococcus aureus. Hemophilus influenzae has been isolated from a significant number of patients also. A number of the beta-lactam and aminoglycoside antibiotics reportedly have altered pharmacokinetic variables in CF. Therapy of acute pulmonary deterioration consists of intravenous antibiotics for two weeks. Antibiotic selection is based on culture and sensitivity results. Currently, the combination of a broad-spectrum penicillin and an aminoglycoside seems to provide the best results. Prophylactic antibiotics are effective if the primary isolates are sensitive to the agents used. Chronic PA infections are problematic because effective oral agents are not available. Aerosolized antibiotics do not improve results over adequate systemic therapy for acute exacerbations. Questions regarding optimal dosages, frequency, and duration of therapy remain.
慢性肺部感染是导致囊性纤维化（CF）患者发病和死亡的重要因素。主要病原体为铜绿假单胞菌（PA）和金黄色葡萄球菌。大量患者中也分离出了流感嗜血杆菌。据报道，一些β-内酰胺类和氨基糖苷类抗生素在CF患者体内的药代动力学变量发生了改变。急性肺部病情恶化的治疗包括静脉注射抗生素两周。抗生素的选择基于培养和药敏结果。目前，广谱青霉素和氨基糖苷类抗生素联合使用似乎能取得最佳效果。如果主要分离菌株对所用药物敏感，预防性使用抗生素是有效的。慢性PA感染存在问题，因为没有有效的口服药物。对于急性加重期，雾化吸入抗生素与充分的全身治疗相比，效果并无改善。关于最佳剂量、用药频率和治疗持续时间的问题仍然存在。
