Oral, inhaled, and intravenous antibiotic choice for treating pulmonary exacerbations in cystic fibrosis.
Oral, inhaled, and intravenous antibiotic choice for treating pulmonary exacerbations in cystic fibrosis.
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DOI：
10.1002/ppul.22652
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发表时间：
2013-07
影响因子：
3.1
通讯作者：
Konstan, Michael W.
中科院分区：
文献类型：
--
作者：
Wagener, Jeffrey S.;Rasouliyan, Lawrence;VanDevanter, Donald R.;Pasta, David J.;Regelmann, Warren E.;Morgan, Wayne J.;Konstan, Michael W.
囊性纤维化患者经常出现肺恶化（PExs）。临床医生以各种方式处理这些恶化的体征和症状。目的探讨PExs术后抗生素治疗及肺功能的相关变化。我们使用2003-5年囊性纤维化流行病学研究的数据来检查抗生素治疗和临床医生报告的PExs相关的即时和长期肺功能改变。在13194例特殊患者中报告了45374例pex。大多数PExs（73%）采用口服抗生素治疗，39%采用静脉注射治疗，24%采用吸入抗生素治疗。非静脉注射与静脉注射抗生素治疗的可能性与患者的年龄、肺部疾病的分期和PEx前肺功能下降的程度有关。治疗后，FEV1的平均改善预测为3.4±12.2%，静脉注射抗生素治疗后的改善预测为5.1±12.7%，高于非静脉注射治疗（预测为2.0±11.6%）。当将前一年的最佳FEV1与PEx后180天进行比较时，预测平均下降3.8±10.5%，抗生素治疗途径之间几乎没有差异。在为期3年的研究中，只有一次急性发作的患者与没有报告急性发作的患者有相似的肺功能丧失。临床医生用口服抗生素治疗大多数PExs，特别是年轻、健康的患者。抗生素治疗可改善肺功能，但随着时间的推移，PExs与肺功能恶化有关。
Patients with cystic fibrosis experience frequent pulmonary exacerbations (PExs). Clinicians manage these episodes of worsening signs and symptoms in a variety of ways. To characterize the antibiotic management and associated change in lung function following PExs. We used 2003-5 data from the Epidemiologic Study of Cystic Fibrosis to examine antibiotic treatment and the immediate and long term lung function change associated with clinician reported PExs. 45,374 PExs were reported in 13,194 unique patients. Most PExs (73%) were treated with oral antibiotics, while 39% were treated IV and 24% were treated with inhaled antibiotics. The likelihood of non-IV vs. IV antibiotic treatment was associated with the patient’s age, stage of lung disease, and magnitude of lung function drop prior to the PEx. Following treatment, the average improvement in the FEV1 was 3.4±12.2 % predicted with a greater (5.1±12.7 % predicted) improvement following IV antibiotic treatment than with non-IV treatment (2.0±11.6 % predicted). When the best FEV1 from the year before was compared with 180 days following the PEx there was an average fall of 3.8±10.5 % predicted with little difference observed between antibiotic treatment routes. Patients with only one exacerbation during the 3-year study had a similar loss of lung function to patients with no reported exacerbations. Clinicians treat the majority of PExs with oral antibiotics, particularly in younger, healthier patients. Pulmonary function improves with antibiotic therapy, however PExs are associated with lung function deterioration over time.
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影响因子：
24.3
作者：
Bradley, J;McAlister, O;Elborn, S
通讯作者：
Elborn, S
影响因子：
5.2
作者：
Latzin, Philipp;Fehling, Maya;Griese, Matthias
通讯作者：
Griese, Matthias
DOI：
10.1164/rccm.201001-0057oc
发表时间：
2010-11-01
影响因子：
24.7
作者：
Collaco, J. Michael;Green, Deanna M.;Mogayzel, Peter J., Jr.
通讯作者：
Mogayzel, Peter J., Jr.
影响因子：
5
作者：
Liou, TG;Adler, FR;Marshall, BC
通讯作者：
Marshall, BC
影响因子：
158.5
作者：
RAMSEY, BW;DORKIN, HL;SMITH, AL
通讯作者：
SMITH, AL