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首页> 外文期刊>The clinical respiratory journal. >Oral antimicrobial use in outpatient cystic fibrosis pulmonary exacerbation management: a single-center experience.
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Oral antimicrobial use in outpatient cystic fibrosis pulmonary exacerbation management: a single-center experience.

机译：在门诊囊性纤维化中口服抗菌药物治疗肺部加重：单中心经验。

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INTRODUCTION: Cystic fibrosis (CF) pulmonary disease is characterized by intermittent episodes of acute lung symptoms known as 'pulmonary exacerbations'. While exacerbations are classically treated with parenteral antimicrobials, oral antibiotics are often used in 'mild' cases. OBJECTIVES: We determined how often management progressed to intravenous (IV) therapy. We also examined multiple courses of oral antimicrobials within one exacerbation, and identified patient factors associated with unsuccessful treatment. METHODS: We performed a retrospective chart audit of oral antibiotic use in CF patients, from March 2009 through March 2010, for 'mild' CF exacerbations. RESULTS: Administration of a single vs multiple courses of oral antibiotics for treatment of 'mild' CF exacerbation avoided progression to IV therapy 79.8% and 50.0% of the time, respectively. Overall, oral antibiotics circumvented the need for IV therapy 73.8% of the time. Using multi-variant analysis, we found multiple patient characteristics to be independent risk factors for oral antibiotic failure including a history of pseudomonas infection [odds ratio (OR) 2.13, confidence interval (CI) 1.29-3.54], CF-related diabetes (OR 1.85, CI 1.00-3.41), allergic Bronchopulmonary aspergillosis (OR 3.81, CI 1.38-10.56), low socioeconomic status (OR 1.67, CI 1.04-2.67), and calculated baseline forced expiratory volume in 1 s (FEV1) < 75% of predicted prior to an acute exacerbation (OR 1.93, CI 1.20-3.08). Decline in FEV1 > 10%, weight for age, body mass index, distance from the CF center and gender were not significant. CONCLUSION: Our observations suggest that one course of oral antimicrobials is frequently effective in outpatient CF pulmonary exacerbations but exacerbations requiring more than one course of oral antibiotics are likely to require IV therapy.
机译：简介：囊性纤维化（CF）肺部疾病的特征是间歇性发作的急性肺部症状（称为“肺部恶化”）。虽然加重是经典的肠胃外抗菌药物治疗，但在“轻度”病例中经常使用口服抗生素。目的：我们确定了管理多长时间进行一次静脉（IV）治疗。我们还在一次加重期间检查了多种疗程的口服抗生素，并确定了与治疗失败相关的患者因素。方法：从2009年3月至2010年3月，我们对CF患者的口服抗生素使用情况进行了回顾性图表审计，以了解CF轻度加重的情况。结果：一次或多个疗程的口服抗生素治疗“轻度” CF急性发作分别避免了79.8％和50.0％的时间接受IV治疗。总体而言，口服抗生素避免了73.8％的时间进行静脉治疗。使用多变量分析，我们发现多个患者特征是口服抗生素失败的独立危险因素，包括假单胞菌感染的历史[比值比（OR）2.13，置信区间（CI）1.29-3.54]，CF相关性糖尿病（OR 1.85，CI 1.00-3.41），过敏性支气管肺曲菌病（OR 3.81，CI 1.38-10.56），低社会经济地位（OR 1.67，CI 1.04-2.67），计算出的1秒基线强迫呼气量（FEV1）<7％在急性发作前预测（OR 1.93，CI 1.20-3.08）。 FEV1下降> 10％，年龄，体重指数，距CF中心的距离和性别均无统计学意义。结论：我们的观察结果表明，一个疗程的口服抗菌药物通常对门诊CF肺病加重有效，但需要超过一个疗程的口服抗生素加重病情可能需要进行静脉治疗。

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