LONG-TERM LOW-DOSE ADMINISTRATION OF ERYTHROMYCIN TO PATIENTS WITH DIFFUSE PANBRONCHIOLITIS
LONG-TERM LOW-DOSE ADMINISTRATION OF ERYTHROMYCIN TO PATIENTS WITH DIFFUSE PANBRONCHIOLITIS
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DOI：
10.1159/000195915
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发表时间：
1991-05-01
期刊：
影响因子：
3.7
通讯作者：
KURASHIMA, A
中科院分区：
文献类型：
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作者：
NAGAI, H;SHISHIDO, H;KURASHIMA, A
虽然弥漫性泛细支气管炎（DPB）预后差，但长期小剂量红霉素（EM）治疗是非常有效的。我们给19名DPB受试者服用EM，每日剂量为400-600 mg，持续2个月以上。16例受试者排痰性咳嗽和呼吸困难缓解，胸部X线照片改善。我们在11名DPB受试者（8名应答者; 3名无应答者）中进行了EM长期低剂量给药后的药代动力学研究。血清和痰液中EM的最高浓度均低于临床致病性H.流感病毒和铜绿假单胞菌是DPB患者痰中常见的病原菌。在EM的吸收方面，应答者和非应答者之间没有观察到差异。结果表明，DPB患者可能对EM产生良好的反应，这是由于抗菌活性以外的机制。观察到EM吸收的个体差异。由于EM在非常低的血清和痰液水平下有效，因此建议即使200 mg/天的EM对于血清和痰EM水平高的DPB患者也有效，并且有必要监测血清和痰中EM的浓度以确定治疗DPB的适当剂量。
Although diffuse panbronchiolitis (DPB) has carried a poor prognosis, long-term low-dose administration of erythromycin (EM) is very effective. We administered EM at a daily dose of 400-600 mg to 19 DPB subjects for more than 2 months. Sixteen subjects were relieved from productive cough and dyspnea, and their chest X-ray pictures were improved. We performed a pharmacokinetic study of EM in 11 DPB subjects (8 responders; 3 nonresponders) after the long-term low-dose administration. The maximal serum and sputum levels of EM were below the MICs of clinically pathogenic H. influenzae and P aeruginosa which were often isolated from the sputum of DPB patients. No difference was observed in the absorption of EM between responders and nonresponders. The results suggested that DPB patients might respond favorably to EM due to mechanisms other than antibacterial activity. Individual variation in the absorption of EM was observed. As EM was effective at very low serum and sputum levels, it was suggested that even 200 mg/day of EM would be effective in DPB patients who had high serum and sputum EM levels and it was necessary to monitor the concentrations of EM in serum and sputum for the treatment of DPB to determine the appropriate dose of EM individually.