Webb A K
Adult Cystic Fibrosis Unit, Wythenshawe Hospital, Manchester, UK.
Scand J Infect Dis Suppl. 1995;96:24-7.
The survival of cystic fibrosis patients has improved through an aggressive, multidisciplinary approach to the therapy of pulmonary sepsis. Intravenous antibiotics play a major role in the care of cystic fibrosis patients, even though it is not possible to achieve persistent bacterial eradication due to the complex microbiology and pathology of these patients. The most important pathogen in older patients is Pseudomonas aeruginosa. The increasing incidence of Pseudomonas cepacia, strains of which can be highly resistant to many antibiotics, also represents an important challenge to the efficacy of antibiotic therapy. Choice of appropriate antimicrobial therapy is hampered by the fact that a single patient may harbour several different pseudomonas phenotypes with variable resistance patterns. Carbapenem antibiotics possess a wide range of activity against most Gram-negative and Gram-positive bacteria and are therefore a useful addition to the antimicrobial armamentarium available to the clinician. The new carbapenem meropenem is well tolerated at high doses by both children and adults. Results from a comparative trial against ceftazidime suggests that meropenem has a place in the management of cystic fibrosis.
通过积极的多学科方法治疗肺部脓毒症，囊性纤维化患者的生存率得到了提高。静脉注射抗生素在囊性纤维化患者的治疗中起着主要作用，尽管由于这些患者复杂的微生物学和病理学情况，不可能实现持续的细菌根除。老年患者中最重要的病原体是铜绿假单胞菌。洋葱伯克霍尔德菌的发病率不断上升，其菌株对许多抗生素具有高度耐药性，这也对抗生素治疗的疗效构成了重大挑战。由于单个患者可能携带几种具有不同耐药模式的不同铜绿假单胞菌表型，因此选择合适的抗菌治疗受到阻碍。碳青霉烯类抗生素对大多数革兰氏阴性和革兰氏阳性细菌具有广泛的活性，因此是临床医生可用的抗菌药物库中的有用补充。新型碳青霉烯类药物美罗培南在儿童和成人中高剂量使用时耐受性良好。一项与头孢他啶对比试验的结果表明，美罗培南在囊性纤维化的治疗中占有一席之地。
