呼吸系统疾病治疗用雾化吸入抗菌药物的研究进展

传统的抗菌药物给药方式(口服或静脉注射)由于药物的理化性质和宿主解剖学特点,感染部位往往达不到有效的抗菌浓度,导致了治疗的失败。雾化吸入疗法因药物直接作用于靶器官,具有起效迅速、疗效佳、全身不良反应少、不需要患者刻意配合等优势,成为治疗呼吸系统相关疾病较为理想的给药方法。目前抗菌药物吸入制剂只有妥布霉素、氨曲南和多黏菌素,正在研制的有环丙沙星、左氧氟沙星、阿米卡星、两性霉素B、万古霉素等。国外在20世纪40年代开始对吸入抗菌药物进行研究,相对国外的研究,国内的相关报道还较少,因此,为给呼吸系统疾病的防治带来临床新路径,对近年来国内外雾化吸入抗菌药物的药效/药动学研究进展进行综述。

Research progress on inhalation of antibiotics for respiratory diseases

Traditional drug administration (orally or intravenously) of antibiotics often can not reach effective concentration at the site of infection due to the different physicochemical properties of the drug and different anatomical features of the host and leads to treatment failure. Nebulization makes medicine directly apply to target organs and has advantages of rapid onset, great effects, less adverse reaction, and no special cooperation. Therefore it became the ideal and important administration for the respiratory system related diseases. At present there are only tobramycin, aztreonam and colistin used as inhalation of antibiotics for respiratory diseases. The others including ciprofloxacin, levofloxacin, amikacin, amphotericin B, vancomycin and so on are developing. As early as 1940s, inhaled antibiotics began to be studied abroad, while domestic studies are seldom reported. The latest research progress on PK/PD inhalation of antibiotics aiming to provide new clinical pathway for the prevention and treatment of respiratory diseases is reviewed in this paper.