Mordasini C, Aebischer C C, Schoch O D
Pneumologische Abteilung, Tiefenauspital Bern.
Schweiz Med Wochenschr. 1997 May 24;127(21):905-10.
Treating chronic Pseudomonas infection of the bronchial tree is a very important part of the treatment strategy in patients with cystic fibrosis. There are only a few antibiotics which are effective against pseudomonas. Many of them soon lead to bacterial resistance (e.g. fluoro-quinolones). Inhaling antibiotics produces high sputum concentrations and low systemic toxicity. Tolerance is good and resistance rare. Several clinical studies, some of them doubleblind placebo controlled, have shown a positive effect of inhaled antibiotics on symptoms, on frequency of necessary i.v. therapies and also on pulmonary function. Most commonly aminoglycosides (tobramycin) and colistin, which is not yet registered in Switzerland, are used. The main indication is chronic therapy of Pseudomonas infection.
治疗支气管树的慢性铜绿假单胞菌感染是囊性纤维化患者治疗策略的非常重要的一部分。仅有少数几种抗生素对铜绿假单胞菌有效。其中许多抗生素很快就会导致细菌耐药（如氟喹诺酮类）。吸入抗生素可在痰液中产生高浓度药物，且全身毒性低。耐受性良好，耐药罕见。多项临床研究，其中一些是双盲安慰剂对照研究，已表明吸入抗生素对症状、必要的静脉治疗频率以及肺功能均有积极作用。最常用的是氨基糖苷类（妥布霉素）和多粘菌素（在瑞士尚未注册）。主要适应证是铜绿假单胞菌感染的长期治疗。
