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Am J Resp Crit Care:阿奇霉素治疗囊性纤维化早期假单胞菌感染疗效分析!

2018-06-12 xing.T MedSci原创

由此可见,阿奇霉素与PEx风险显著降低和体重持续改善相关,但对早期Pa患儿微生物学结局无影响。

通常用吸入型抗假单胞菌抗生素如妥布霉素吸入溶液(TIS)处理铜绿假单胞菌(Pa)的新分离物。通过降低肺部恶化(PEx)和炎症的风险来补充传统抗微生物的治疗方法可能最终延长Pa复发的时间。近日,呼吸内科以及重症医学领域权威杂志Am J Resp Crit Care上发表了一篇研究文章,为了验证这样一个假设,即在CF和早期Pa患儿中添加阿奇霉素至TIS中可降低PEx的风险并延长了Pa复发的时间。

OPTIMIZE试验是一项多中心、双盲、随机、安慰剂对照、为期18个月的在6月至18岁CF和早期Pa患儿中进行的试验。给予阿奇霉素或安慰剂每周3次,添加到标准化的TIS中。该研究的主要终点是PEx需要抗生素治疗的时间,次要终点为Pa复发的时间,以及其他临床和安全性结果。

221名参与者(111名接受安慰剂,110名接受阿奇霉素)被纳入研究。因为该试验已达到预先设定的临床疗效边界而停止招募。与安慰剂相比,阿奇霉素组的PEx风险降低了44%(风险比[HR]:0.56,95%CI:0.37-0.83,p=0.004)。与安慰剂相比,阿奇霉素组体重增加1.27kg(95%CI:0.01-2.52,p=0.046)。微生物学、临床或安全性终点没有显著差异。

由此可见,阿奇霉素与PEx风险显著降低和体重持续改善相关,但对早期Pa患儿微生物学结局无影响。

原始出处:

Nicole Mayer-Hamblett,et al.Azithromycin for Early Pseudomonas Infection in Cystic Fibrosis: The Optimize Randomized Trial.AM J RESP CRIT CARE 2018.https://doi.org/10.1164/rccm.201802-0215OC        

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    2018-12-08 wolongzxh
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    2018-06-15 phoebeyan520

    很好很好.学习了

    0

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    2018-06-12 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2018-06-12 龙胆草

    学习谢谢分享

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Lancet:研究报告耐阿奇霉素梅毒螺旋体亚种的出现和传播

雅司病是在至少 14 个热带地区国家儿童慢性毁容性溃疡的根本病因。WHO 新采用的雅司病根除策略使用单轮阿奇霉素集体治疗,然后进行靶向治疗方案,来自试点研究的数据表明雅司病短期内显著减少。我们评估了 WHO 雅司病根除策略的长期效果

警惕!阿奇霉素配伍禁忌和相互作用

阿奇霉素对革兰阴性菌的抗菌活性是红霉素的2~8倍(抗革兰阳性菌的活性比红霉素略差),对肺炎支原体的作用是大环内酯类中的最强者。阿奇霉素的组织浓度较同期血药浓度高出10~100倍,炎症部位浓度比非炎症部位高达6倍以上。阿奇霉素血浆半衰期35~48h,患者口服用药依从性好。

NEJM:阿奇霉素治疗可降低撒哈拉以南非洲地区儿童死亡风险

在撒哈拉以南地区的学龄前儿童中进行阿奇霉素治疗可显著降低儿童死亡风险,特别是尼日尔,但这一策略的普及尚需考察耐药性的影响

Am J Epidemiol:用阿奇霉素治疗沙眼与衣原体ompA多样性之间的关系

加利福尼亚大学旧金山分校的Chin SA近日在Am J Epidemiol发表了一篇文章,他们对大规模使用阿奇霉素导致衣原体遗传多样性降低,并有可能再次导致感染复发的假设进行研究,最终认为其证据不支持ompA多样性与眼睛衣原体传播有关。

头孢菌素+阿奇霉素,究竟合不合理?

传统理论认为:β-内酰胺类抗生素是繁殖期杀菌药,能和静止期杀菌药物氨基糖苷类联用,但不宜与快速抑菌药如大环内酯类抗菌药物联用,两者联用会减弱β-内酰胺类抗菌药物的杀菌效果。但是,近年来大量实验研究及临床实践证明:两类药物联用并无拮抗作用,会产生协同互补的效果。

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