在慢性阻塞性肺病中进行预防性抗生素治疗
Samantha C Herath1, Phillippa Poole2
1Day Unit, Department of Respiratory Medicine, Montreal Chest Institute, Montreal, Quebec, Canada.
JAMA
|June 4, 2014
概括
预防性宏类抗生素可以减少慢性阻塞性肺病 (COPD) 恶化,持续使用. 虽然连续和脉冲抗生素疗法都改善了与健康有关的生活质量 (HRQOL),但这些收益在临床上并不显著.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 慢性阻塞性肺病 (COPD) 是一种进展性肺病,其特点是持续的呼吸道症状和频繁的恶化.
- 恶化严重影响患者的发病率,死亡率和医疗费用.
- 研究了预防性抗生素策略,以缓解COPD恶化并改善生活质量.
研究的目的:
- 评估预防性抗生素治疗在减少COPD患者恶化的疗效.
- 评估预防性抗生素对COPD患者与健康相关的生活质量 (HRQOL) 的影响.
主要方法:
- 随机对照试验的系统审查和元分析.
- 包括比较连续或脉冲宏类抗生素预防与安慰剂的研究.
- 评估包括COPD恶化率在内的主要结果和包括HRQOL在内的二次结果.
主要成果:
- 持续的宏类抗生素预防与临床显著减少COPD恶化有关.
- 脉冲性宏类抗生素预防没有显示出严重恶化的显著减少.
- 连续和脉冲的宏类药物疗法都显示了HRQOL的改善,但这些变化没有达到临床意义.
结论:
- 持续预防性宏类抗生素的使用是减少COPD患者恶化的有效策略.
- 虽然HRQOL可能有所改善,但预防性抗生素改善的临床意义需要进一步调查.
- 目前的证据支持在选择的COPD患者中持续使用类药物来预防恶化.
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