A randomized controlled trial of filgrastim as an adjunct to antibiotics for treatment of hospitalized patients with community-acquired pneumonia
A randomized controlled trial of filgrastim as an adjunct to antibiotics for treatment of hospitalized patients with community-acquired pneumonia
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DOI：
10.1086/515694
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发表时间：
1998-10-01
影响因子：
6.4
通讯作者：
Wilson, J
中科院分区：
文献类型：
--
作者：
Nelson, S;Belknap, SM;Wilson, J
由于中性粒细胞在宿主防御中的关键作用，假设用非格司亭刺激中性粒细胞的产生和功能将改善社区获得性肺炎住院患者的结局。为了验证这一假设，对这些患者进行了一项非格司亭（300 μ g/天，长达10天）作为抗生素辅助治疗的随机、安慰剂对照、多中心试验。结果指标包括发病率消退时间（TRM，体温、呼吸频率、血氧和胸片的综合指标）、28天死亡率、住院时间和不良事件。非格司亭使血液中性粒细胞增加3倍，但TRM、死亡率和住院时间不受影响。然而，治疗加速了放射学改善，并似乎减少了严重并发症（例如，脓胸、成人呼吸窘迫综合征和弥散性血管内凝血）。非格司亭给药在这些患者中安全且耐受性良好。需要更多的试验来确定这种方法治疗传染病的价值。
Because of the critical role of neutrophils in host defenses, it was hypothesized that stimulation of neutrophil production and function with Filgrastim would improve the outcome of hospitalized patients with community-acquired pneumonia, To test this hypothesis, a randomized, placebo-controlled, multicenter trial of Filgrastim (300 mu g/day up to 10 days) as an adjunct to antibiotics was conducted for these patients. Outcome measures included time to resolution of morbidity (TRM, a composite measure of temperature, respiratory rate, blood oxygenation, and chest radiograph), 28-day mortality, length of stay, and adverse events. Filgrastim increased blood neutrophils 3-fold, but TRM, mortality, and length of hospitalization were not affected, Treatment, however, accelerated radiologic improvement and appeared to reduce serious complications (e.g,, empyema, adult respiratory distress syndrome, and disseminated intravascular coagulation). Filgrastim administration was safe and well tolerated in these patients. Additional trials are needed to establish the value of this approach to treatment of infectious diseases.