Sheldon C D, Assoufi B K, Hodson M E
Department of Cystic Fibrosis, Royal Brompton National Heart & Lung Hospitals, Chelsea, London, U.K.
Respir Med. 1993 Nov;87(8):587-93. doi: 10.1016/s0954-6111(05)80261-6.
In 31 adult patients with cystic fibrosis (CF) who were chronically infected with Pseudomonas aeruginosa we examined the effect of giving regular three monthly oral ciprofloxacin. Patients received ciprofloxacin or placebo for 10 days every 3 months for 1 yr in a randomized, double-blind, placebo-controlled study. During each course of treatment patients receiving ciprofloxacin reported an improvement in cough, sputum production and peak expiratory flow (PEF) P = < 0.005. During the year of study patients receiving ciprofloxacin showed an improvement in PEF when compared with those receiving placebo (P = < 0.05) but the changes in FEV1 and FVC were not statistically different in either group. Regular oral ciprofloxacin was well tolerated but did not prevent hospital admissions or reduce the number of courses of intravenous antibiotics throughout the year. The median MIC to ciprofloxacin in the active treatment group rose from 0.5 mg l-1 to 0.75 mg l-1 during treatment. We conclude that CF patients are likely to benefit from oral ciprofloxacin for exacerbations of respiratory symptoms. However, regular treatment with ciprofloxacin over 1 yr improves PEF but does not reduce the rate of hospital admissions with acute exacerbations of respiratory symptoms.
在31例长期感染铜绿假单胞菌的成年囊性纤维化（CF）患者中，我们研究了每三个月定期口服环丙沙星的效果。在一项随机、双盲、安慰剂对照研究中，患者每3个月接受环丙沙星或安慰剂治疗10天，持续1年。在每个治疗疗程中，接受环丙沙星治疗的患者报告咳嗽、咳痰和呼气峰值流速（PEF）均有改善（P =< 0.005）。在研究的这一年中，与接受安慰剂的患者相比，接受环丙沙星治疗的患者的PEF有所改善（P =< 0.05），但两组的第一秒用力呼气容积（FEV1）和用力肺活量（FVC）变化无统计学差异。定期口服环丙沙星耐受性良好，但并不能预防住院或减少全年静脉使用抗生素的疗程数。在积极治疗组中，治疗期间环丙沙星的最低抑菌浓度（MIC）中位数从0.5 mg/l升至0.75 mg/l。我们得出结论，CF患者可能会从口服环丙沙星治疗呼吸道症状加重中获益。然而，超过1年的环丙沙星常规治疗可改善PEF，但不能降低呼吸道症状急性加重的住院率。
