The effect of oral and intravenous antimicrobials on pulmonary exacerbation recovery in cystic fibrosis.
The effect of oral and intravenous antimicrobials on pulmonary exacerbation recovery in cystic fibrosis.
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DOI：
10.1016/j.jcf.2021.02.012
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Goss CH
中科院分区：
文献类型：
--
作者：
VanDevanter EJ;Heltshe SL;Skalland M;Lechtzin N;Nichols D;Goss CH
回顾性研究表明，尽管对 PO 治疗对肺功能恢复的相对影响或对肺部疾病进展的长期影响知之甚少，但口服 (PO) 治疗的囊性纤维化 (CF) 肺部病情加重 (PEx) 多于静脉注射 (IV) 抗菌药物。先前的研究表明，与静脉注射治疗相比，口服治疗可能会导致肺功能恢复较慢。我们使用 eICE 研究 (NCT01104402) 的纵向家庭肺量测定数据来比较通过家庭肺量测定和症状评估诊断的 PEx 的 PO 与 IV 抗菌治疗反应。青少年和成人 eICE 参与者每周进行两次家庭肺活量测定，持续一年。 PEx 通过协议定义的算法来诊断，该算法根据 1 秒内预测用力呼气量百分比 (ppFEV1) 的变化和/或呼吸体征和症状进行诊断。 PO 和 IV 处理的 PEx 按初始 ppFEV1 下降幅度进行分组。组 ppFEV1 治疗反应采用多变量重复测量线性回归建模。在 56 名参与者的 87 名合格 PEx 中，62 名接受 PO 治疗，25 名接受 IV 治疗。从最佳 ppFEV1 到 PEx 开始的平均下降为 11.0 [95%CI: 8.5, 13.5]，治疗组平均值相似 (p=0.72)。接受 IV 治疗的 PEx 参与者的平均反应比接受 PO 治疗的参与者高 0.72 [0.24, 1.20] ppFEV1/天，后者的 ppFEV1 恢复程度最低。许多 PO 治疗参与者的 ppFEV1 较基线下降 <10 时，病情往往会恶化或 ppFEV1 没有改善。这些结果表明，在该队列中，CF PEx 口服抗菌治疗在治疗期间改善 ppFEV1 方面的效果不如静脉注射有效。
Retrospective studies indicate that more cystic fibrosis (CF) pulmonary exacerbations (PEx) are treated with oral (PO) than with intravenous (IV) antimicrobials despite little knowledge of the relative effects of PO treatment on lung function recovery or long-term impacts on lung disease progression. Previous studies have suggested that PO treatment may be associated with slower lung function recovery compared with IV treatment. We used longitudinal home spirometry data from the eICE study (NCT01104402) to compare PO versus IV antimicrobial treatment responses for PEx diagnosed by home spirometry and symptom assessment. Adolescent and adult eICE participants performed home spirometry twice weekly for one year. PEx were diagnosed by a protocol-defined algorithm of change in percent predicted forced expiratory volume in 1 second (ppFEV1) and/or respiratory signs and symptoms. PO- and IV-treated PEx were grouped by initial ppFEV1 drop magnitude. Group ppFEV1 treatment responses were modeled with multivariate, repeat-measure linear regression. Of 87 qualifying PEx from 56 participants, 62 were PO-treated and 25 were IV-treated. The average drop from best ppFEV1 to PEx start was 11.0 [95%CI: 8.5, 13.5] with similar treatment group means (p=0.72). Participants with IV-treated PEx averaged 0.72 [0.24, 1.20] ppFEV1/day greater response than those treated with PO, who experienced minimal ppFEV1 recovery. Many PO-treated participants who had <10 ppFEV1 drop from baseline tended to worsen or show no ppFEV1 improvement. These results suggest that, in this cohort, PO antimicrobial treatment of CF PEx were less effective than IVs at improving ppFEV1 during treatment.
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影响因子：
3.1
作者：
Wagener, Jeffrey S.;Rasouliyan, Lawrence;VanDevanter, Donald R.;Pasta, David J.;Regelmann, Warren E.;Morgan, Wayne J.;Konstan, Michael W.
通讯作者：
Konstan, Michael W.
DOI：
10.1164/rccm.200909-1421oc
发表时间：
2010-09-01
影响因子：
24.7
作者：
Sanders, Don B.;Bittner, Rachel C. L.;Goss, Christopher H.
通讯作者：
Goss, Christopher H.
影响因子：
5
作者：
Liou, TG;Adler, FR;Marshall, BC
通讯作者：
Marshall, BC
影响因子：
3.1
作者：
WANG, XB;DOCKERY, DW;FERRIS, BG
通讯作者：
FERRIS, BG
DOI：
10.1164/rccm.200202-087oc
发表时间：
2002-12-15
影响因子：
24.7
作者：
Mayer-Hamblett, N;Rosenfeld, M;Aitken, ML
通讯作者：
Aitken, ML