Elusiveness of ideal approach to Pseudomonas aeruginosa infection complicating cystic fibrosis.

Elusiveness of ideal approach to Pseudomonas aeruginosa infection complicating cystic fibrosis.
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铜绿假单胞菌感染并发囊性纤维化的理想方法难以实现。

DOI:
10.1016/s0140-6736(00)02600-3
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发表时间:
2000
期刊:
Lancet (London, England)
影响因子:
--
通讯作者:
Liou,TG
Liou,TG
中科院分区:
--
文献类型:
--
作者:
Marshall,BC;Liou,TG

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Scientific advances in the understanding of cystic fibrosis instill hope in patients and their health-care providers that a cure is on the horizon. However, in reality cystic fibrosis is a burdensome disease with substantial morbidity and mortality. Pulmonary disease remains the major cause of mortality, and Pseudomonas aeruginosa is by far the most common pathogen. Conventional wisdom has been that colonisation and infection with this organism are inevitable. The standard treatment approach has centered on antibiotics for acute exacerbations.Orthodox views on Pseudomonas aeruginosa infection have been challenged in Denmark with strategies to prevent colonisation, 1 aggressive treatment aimed at eradication of initial infection, 2 and a regular schedule of parenteral antibiotics for chronically infected patients, irrespective of clinical status. 3 The scheduled-antibiotic strategy, implemented in the mid-to-late 1970s, was associated with better survival than had been found in a historical control group, but it has not been widely adopted worldwide for several reasons. Improvement in survival with cystic fibrosis throughout the industrialised world in the 1970s (in part, attributed to improved nutrition and the formation of specialised care centers) cast special doubt about the validity of historical controls. There were also concerns about cost and the development of antibiotic resistance and allergies. Nonetheless, the Danish approach generated intense interest and lively debates. Even so, no well-
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