慢性阻塞性肺疾病急性加重期抗菌药物治疗进展

Antibiotics treatment in acute exacerbation of chronic obstructive pulmonary disease

慢性阻塞性肺疾病(COPD)经常伴有急性加重症状,引起急性加重最常见的原因是气道感染。分离自COPD急性加重(AECOPD)患者下呼吸道分泌物的主要病原菌为流感嗜血杆菌、肺炎链球菌、卡他莫拉菌、肺炎支原体和肺炎衣原体。慢性阻塞性肺疾病全球防治倡议(GOLD)推荐了AECOPD的抗菌药物治疗方案,其用药途径(口服或静脉)取决于患者的口服能力和抗菌药物的药动学特性,采用静脉用药者在临床病情稳定后应及时转换为口服用药,推荐的抗菌药物疗程为5～7天。

Chronic obstructive pulmonary disease （COPD） is often associated with acute exacerbation of synptoms. The most common cause of an exacerbation is infection of the airway, but the causes of about one-third of severe exacerbations can not be identified. The infection agents in acute exacerbation of COPD （AECOPD） can be viral or bacterial. The predominant bacteria isolated from the lower airways of patients with AECOPD are H.influenzae, S.pneumoniae and Chlamydia pneumoniae. GOLD provides recommended antibiotics treatment for AECOPD. The routte of administration （oral or intravenous） depends on the ability of patients＇ taking medicine and the pharmacokinetics of antibiotics. If intravenous route must be used, switching to oral is recommended when clinical stabilization permits. The course of antibiotics treatment in patients with AECOPD could be 5 to 7 days.