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囊性纤维化患者感染的治疗干预措施:IV期试验综述

Therapeutic Interventions for Infections in Cystic Fibrosis Patients: A Review of Phase IV Trials.

作者信息

Alqasmi Mohammed

机构信息

Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra 11961, Saudi Arabia.

出版信息

J Clin Med. 2024 Oct 30;13(21):6530. doi: 10.3390/jcm13216530.

Abstract

() poses a significant threat to individuals with cystic fibrosis (CF), as this bacterium is highly adaptable and resistant to antibiotics. While early-stage infections can often be eradicated with aggressive antibiotic therapy, chronic infections are nearly impossible to eliminate and require treatments that focus on long-term bacterial suppression. Without such suppression, these persistent infections can severely damage the lungs, leading to serious complications and a reduced life expectancy for CF patients. Evidence for a specific treatment regimen for managing Pa infections in CF patients remains limited. This narrative review provides a detailed analysis of antimicrobial therapies assessed in completed phase IV trials, focusing on their safety and efficacy, especially with prolonged use. Key antibiotics, including tobramycin, colistin, meropenem, aztreonam, ceftolozane/tazobactam, ciprofloxacin, and azithromycin, are discussed, emphasizing their use, side effects, and delivery methods. Inhaled antibiotics are preferred for their targeted action and minimal side effects, while systemic antibiotics offer potency but carry risks like nephrotoxicity. The review also explores emerging treatments, such as phage therapy and antibiofilm agents, which show promise in managing chronic infections. Nonetheless, further research is necessary to enhance the safety and effectiveness of existing therapies while investigating new approaches for better long-term outcomes.

摘要

()对囊性纤维化(CF)患者构成重大威胁,因为这种细菌具有高度适应性且对抗生素耐药。虽然早期感染通常可以通过积极的抗生素治疗根除,但慢性感染几乎无法消除,需要采取专注于长期抑制细菌的治疗方法。如果没有这种抑制,这些持续性感染会严重损害肺部,导致严重并发症并缩短CF患者的预期寿命。关于CF患者管理铜绿假单胞菌(Pa)感染的特定治疗方案的证据仍然有限。这篇叙述性综述对在已完成的IV期试验中评估的抗菌疗法进行了详细分析,重点关注其安全性和有效性,尤其是长期使用时。讨论了关键抗生素,包括妥布霉素、黏菌素、美罗培南、氨曲南、头孢他啶/阿维巴坦、环丙沙星和阿奇霉素,强调了它们的用法、副作用和给药方法。吸入性抗生素因其靶向作用和最小的副作用而更受青睐,而全身性抗生素虽有药效但存在肾毒性等风险。该综述还探讨了新兴治疗方法,如噬菌体疗法和抗生物膜药物,它们在管理慢性感染方面显示出前景。尽管如此,仍需要进一步研究以提高现有疗法的安全性和有效性,同时研究新方法以获得更好的长期疗效。

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