Обострение хронической обструктивной болезни легких: выбор эмпирической антибиотикотерапии‌‌‌

Обложка
  • Авторы: Батурова В.Ю.1, Малявин А.Г.2
  • Учреждения:
    1. ГБУЗ Городская клиническая больница №1 им. Н.И.Пирогова Департамента здравоохранения г. Москвы
    2. ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России
  • Выпуск: Том 17, № 11 (2015)
  • Страницы: 25-30
  • Раздел: Статьи
  • URL: https://journals.rcsi.science/2075-1753/article/view/94338
  • ID: 94338

Цитировать

Полный текст

Аннотация

Обострения хронической обструктивной болезни легких (ХОБЛ) имеют важное прогностическое значение для течения заболевания. Большинство обострений являются инфекционно-зависимыми, причем преимущественное этиологическое значение играют респираторные вирусы, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae , а также Pseudomonas aeruginosa и Enterobacteriaceae у клинически и соматически отягощенных пациентов. Эмпирическое назначение антибактериального препарата при обострении ХОБЛ основано на тяжести обострения и стратификации риска инфицирования полирезистентными возбудителями. Оптимальными антибактериальными препаратами для лечения среднетяжелого обострения у пациентов, не нуждающихся в госпитализации, оказываются амоксициллин/клавуланат и респираторные фторхинолоны.

Об авторах

Вера Юрьевна Батурова

ГБУЗ Городская клиническая больница №1 им. Н.И.Пирогова Департамента здравоохранения г. Москвы

Email: verabaturova@gmail.com
врач анестезиолог-реаниматолог ГБУЗ ГКБ №1 им. Н.И.Пирогова 119049, Россия, Москва, Ленинский пр-т, д. 8

Андрей Георгиевич Малявин

ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России

Email: maliavin@mail.ru
д-р мед. наук, проф каф. фтизиатрии и пульмонологии лечебного фак-та ГБОУ ВПО МГМСУ им. А.И.Евдокимова 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1

Список литературы

  1. Козлов Р.С., Сивая О.В., Кречикова О.И., Иванчик Н.В. Динамика резистентности Streptococcus pneumoniae к антибиотикам в России за период 1999-2009 гг. Клин. микробиология и антимикроб. химиотерапия. 2010; 12 (4): 329-41.
  2. Чучалин А.Г., Синопальников А.И., Козлов Р.С. и др. Внебольничная пневмония у взрослых: профилактические рекомендации по диагностике, лечению и профилактике (Пособие для врачей). Клин. микробиология и антимикроб. химиотерапия. 2010; 12 (3): 186-225.
  3. American Thoracic Society/European Respiratory Society Task Force. Standards for the Diagnosis and Management of Patients with COPD [Internet]. Version 1.2 http://www.thoracic.org/go/copd (Accessed on October 20, 2011)
  4. Anthonisen N.R, Manfreda J, Warren C.P et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196.
  5. Balter M.S, La Forge J, Low D.E et al. Canadian guidelines for the management of acute exacerbations of chronic bronchitis. Can Respir J 2003; 10 (Suppl. B): 3B.
  6. Bartlett J.G. Diagnostic accuracy of transtracheal aspiration bacteriologic studies. Am Rev Respir Dis 1977; 115: 777.
  7. Beaty C.D, Grayston J.T, Wang S.P et al. Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1991; 144: 1408.
  8. BioFire Diagnostics. Film Array Respiratory Panel. http://www.biofiredx.com/pdfs/Film-Array/InfoSheet,%20FilmArray%20Respiratory%20Panel-0229.pdf
  9. Blasi F, Legnani D, Lombardo V.M et al. Chlamydia pneumoniae infection in acute exacerbations of COPD. Eur Respir J 1993; 6: 19.
  10. Caliendo A.M. Multiplex PCR and emerging technologies for the detection of respiratory pathogens. Clin Infect Dis 2011; 52 (Suppl. 4): S326.
  11. Chin C.L, Manzel L.J, Lehman E.E et al. Haemophilusinfluenzae from patients with chronic obstructive pulmonary disease exacerbation induce more inflammation than colonizers. Am J Respir Crit Care Med 2005; 172: 85.
  12. Connors A.F, Jr Dawson N.V, Thomas C et al Outcomes following acute exacerbation of severe chronic obstructive lung disease: the SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments) [erratum published in Am J Respir Crit Care Med 1997; 155: 386]. Am J Respir Crit Care Med 1996; 154: 959-67.
  13. Daniels J.M, Snijders D, De Graaff C.S et al. Antibiotics in addition to systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2010; 181: 150.
  14. Ewig S, Soler N, Gonzalez J et al. Evaluation of antimicrobial treatment in mechanically ventilated patients with severe chronic obstructive pulmonary disease exacerbations. Crit Care Med 2000; 28 (3): 692-7.
  15. Fagon J.Y, Chastre J, Trouillet J.L et al. Characterization of distal bronchial microflora during acute exacerbation of chronic bronchitis. Use of the protected specimen brush technique in 54 mechanically ventilated patients. Am Rev Respir Dis 1990; 142: 1004.
  16. Falagas M.E, Avgeri S.G, Matthaiou D.K et al. Short - versus long - duration antimicrobial treatment for exacerbations of chronic bronchitis: a meta - analysis. J Antimicrob Chemother 2008; 62: 442.
  17. Falsey A.R, Hennessey P.A, Formica M.A et al. Respiratory syncytial virus infection in elderly and high - risk adults. N Engl J Med 2005; 352: 1749.
  18. Garcia-Vidal C.P, Almagro V, Romani M et al. Pseudomonas Aeruginosa in Patients Hospitalised for COPD Exacerbation: A Prospective Study. Eur Respir J 2009; 34 (5): 1072-8.
  19. Gaydos C.A. What is the role of newer molecular tests in the management of CAP? Infect Dis Clin North Am 2013; 27: 49.
  20. Global strategy for the diagnosis, management and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2015. http://www.goldcopd.org
  21. Greenberg S.B, Allen M, Wilson J, Atmar R.L. Respiratory viral infections in adults with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000; 162: 167.
  22. Groenewegen K.H, Schols A.M.W.J, Wouters E.F.M. Mortality and Mortality-Related Factors after Hospitalization for Acute Exacerbation of COPD. Chest 2003; 124 (2): 459-67.
  23. Gump D.W, Phillips C.A, Forsyth B.R et al. Role of infection in chronic bronchitis. Am Rev Respir Dis 1976; 113: 465.
  24. Hamelin M.E, Côtù S, Laforge J et al. Human metapneumovirus infection in adults with community - acquired pneumonia and exacerbation of chronic obstructive pulmonary disease. Clin Infect Dis 2005; 41: 498.
  25. Lieberman D, Shimoni A, Shemer-Avni Y et al. Respiratory viruses in adults with community - acquired pneumonia. Chest 2010; 138: 811.
  26. Llor C, Moragas A, Hernández S et al. Efficacy of antibiotic therapy for acute exacerbations of mild to moderate chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012; 186: 716.
  27. Mallia P, Johnston S.L. How viral infections cause exacerbation of airway diseases. Chest 2006; 130:1203.
  28. Mc Namara M.J, Phillips I.A, Williams O.B. Viral and Mycoplasma pneumoniae infections in exacerbations of chronic lung disease. Am Rev Respir Dis 1969; 100: 19.
  29. Miravitlles M, Murio C, Guerrero T. Factors associated with relapse after ambulatory treatment of acute exacerbations of chronic bronchitis. DAFNE Study Group. Eur Respir J 2001; 17: 928.
  30. Monsó E, Ruiz J, Rosell A et al. Bacterial infection in chronic obstructive pulmonary disease. A study of stable and exacerbated outpatients using the protected specimen brush. Am J Respir Crit Care Med 1995; 152: 1316.
  31. Murphy T.F, Brauer A.L, Eschberger K et al. Pseudomonas aeruginosa in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2008; 177: 853.
  32. Murphy T.F, Brauer A.L, Sethi S et al. Haemophilus haemolyticus: a human respiratory tract commensal to be distinguished from Haemophilus influenzae. J Infect Dis 2007; 195: 81.
  33. Murphy T.F, Parameswaran G.I. Moraxella catarrhalis, a human respiratory tract pathogen. Clin Infect Dis 2009; 49: 124.
  34. Murphy T.F. Pseudomonas aeruginosa in adults with chronic obstructive pulmonary disease. Curr Opin Pulm Med 2009; 15: 138.
  35. Nouira S, Marghli S, Besbes L et al. Standard versus newer antibacterial agents in the treatment of severe acute exacerbation of chronic obstructive pulmonary disease: a randomized trial of trimethoprim - sulfamethoxazole versus ciprofloxacin. Clin Infect Dis 2010; 51: 143.
  36. Nseir S, Cavestri B, Di Pompeo C et al. Factors predicting bacterial involvement in severe acute exacerbations of chronic obstructive pulmonary disease. Respiration 2008; 76: 253.
  37. Papadopoulos N.G, Bates P.J, Bardin P.G et al. Rhinoviruses infect the lower airways. J Infect Dis 2000; 181: 1875.
  38. Papi A, Bellettato C.M, Braccioni F et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med 2006; 173: 1114.
  39. Petty T.L. Definitions in chronic obstructive pulmonary disease. Clin Chest Med 1990; 11: 363.
  40. Poritz M.A, Blaschke A.J, Byington C.L et al. Film Array, an automated nested multiplex PCR system for multipathogen detection: development and application to respiratory tract infection. PLoS One 2011; 6: e26047.
  41. Roede B.M, Bresser P, Prins J.M et al. Reduced risk of next exacerbation and mortality associated with antibiotic use in COPD. Eur Respir J 2009; 33: 282.
  42. Rohde G, Wiethege A, Borg I et al. Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalisation: a case - control study. Thorax 2003; 58: 37.
  43. Rosell A, Monsó E, Soler N et al. Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease. Arch Intern Med 2005; 165: 891.
  44. Rothberg M.B, Pekow P.S, Lahti M et al. Antibiotic therapy and treatment failure in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. JAMA 2010; 303: 2035.
  45. Sapey E, Stockley R.A. COPD exacerbations.2: aetiology. Thorax 2006; 61: 250.
  46. Schuetz P, Müller B, Christ-Crain M et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev 2012; 9: CD007498.
  47. Seemungal T, Harper-Owen R, Bhowmik A et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164: 1618.
  48. Sethi S, Murphy T.F. Acute exacerbations of chronic bronchitis: new developments concerning microbiology and pathophysiology - impact on approaches to risk stratification and therapy. Infect Dis Clin North Am 2004; 18: 861.
  49. Sethi S, Murphy T.F. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 2008; 359: 2355.
  50. Sethi S, Sethi R, Eschberger K et al. Airway bacterial concentrations and exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 176: 356.
  51. Sethi S. Molecular diagnosis of respiratory tract infection in acute exacerbations of chronic obstructive pulmonary disease. Clin Infect Dis 2011; 52 (Suppl. 4): S290.
  52. Siddiqi A, Sanjay S. Optimizing Antibiotic Selection in Treating COPD Exacerbations. Int J Chronic Obstruct Pulm Dis 2008; 3 (1): 31.
  53. Siempos I.I, Dimopoulos G, Korbila I.P et al. Macrolides, quinolones and amoxicillin/clavulanate for chronic bronchitis: a meta - analysis. Eur Respir J 2007; 29: 1127.
  54. Siripataravanit S, Phaicharoen R, Termsetcharoen S, Klangprapun N. Bacteria associated with acute exacerbations of chronic obstructive pulmonary disease requiring mechanical ventilation and antimicrobial management in Respiratory Care Unit of Central Chest Institute of Thailand. J Med Assoc Thai 2012; 95 (Suppl. 8): S11-8.
  55. Smith C.B, Golden C.A, Kanner R.E, Jr Renzetti A.D. Association of viral and Mycoplasma pneumoniae infections with acute respiratory illness in patients with chronic obstructive pulmonary diseases. Am Rev Respir Dis 1980; 121: 225.
  56. Soler N, Esperatti M, Ewig S et al. Sputum purulence - guided antibiotic use in hospitalised patients with exacerbations of COPD. Eur Respir J 2012; 40: 1344.
  57. Stefan M.S, Rothberg M.B, Shieh M.S et al. Association between antibiotic treatment and outcomes in patients hospitalized with acute exacerbation of COPD treated with systemic steroids. Chest 2013; 143: 82.
  58. Stockley R.A, O'Brien C, Pye A, Hill S.L. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD. Chest 2000; 117: 1638.
  59. Stoller J.K. Clinical practice. Acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 2002; 346: 988.
  60. Tan W.C, Xiang X, Qiu D et al. Epidemiology of respiratory viruses in patients hospitalized with near - fatal asthma, acute exacerbations of asthma, or chronic obstructive pulmonary disease. Am J Med 2003; 115: 272.
  61. Vollenweider D.J, Jarrett H, Steurer-Stey C.A et al. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2012; 12: CD010257.
  62. Wilkinson T.M, Hurst J.R, Perera W.R et al. Effect of interactions between lower airway bacterial and rhinoviral infection in exacerbations of COPD. Chest 2006; 129: 317.
  63. Wilson R, Anzueto A, Miravitlles M, et al. Moxifloxacin versus amoxicillin/clavulanic acid in outpatient acute exacerbations of COPD: MAESTRAL results. Eur Respir J

© ООО "Консилиум Медикум", 2015

Creative Commons License
Эта статья доступна по лицензии Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Данный сайт использует cookie-файлы

Продолжая использовать наш сайт, вы даете согласие на обработку файлов cookie, которые обеспечивают правильную работу сайта.

О куки-файлах