Bacteria, antibiotics and COPD

被引:55
作者
Wilson, R
机构
[1] Royal Brompton Hosp, Natl Heart & Lung Inst, London, England
[2] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London, England
关键词
antibiotic resistance; antibiotics; chronic obstructive pulmonary disease; pulmonary infections;
D O I
10.1183/09031936.01.17509950
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Bacterial infection is one of several important causes of exacerbations of chronic obstructive pulmonary disease (COPD) that may coexist. COPD is a heterogeneous condition and the incidence of bacterial infection is not uniform; mucus hypersecretion may be an important risk factor. The bacteriology of infections varies depending on the severity of the underlying airway disease. There is now a much better understanding of the pathogenesis of bacterial infections of the respiratory mucosa. Lower airway bacterial colonization may be a stimulus for chronic inflammation and may influence the interval between exacerbations. Antibiotic resistance has increased in all the major pathogens. Antibiotics are an important part of the treatment of acute exacerbations of COPD and the decision about whether to give an antibiotic can be made on clinical grounds. It is more difficult to decide, on the available evidence, whether patient characteristics and the risk of antibiotic resistance should influence choice of empiric antibiotic treatment. Most new antibiotics are modifications of existing structures, suggesting that every effort should be made to conserve the sensitivity of current antibiotics by using them appropriately.
引用
收藏
页码:995 / 1007
页数:13
相关论文
共 108 条
[1]   Serial measurements of exhaled nitric oxide during exacerbations of chronic obstructive pulmonary disease [J].
Agustí, AGN ;
Villaverde, JM ;
Togores, B .
EUROPEAN RESPIRATORY JOURNAL, 1999, 14 (03) :523-528
[2]   EFFECTS OF HUMAN NEUTROPHIL ELASTASE AND PSEUDOMONAS-AERUGINOSA PROTEINASES ON HUMAN RESPIRATORY EPITHELIUM [J].
AMITANI, R ;
WILSON, R ;
RUTMAN, A ;
READ, R ;
WARD, C ;
BURNETT, D ;
STOCKLEY, RA ;
COLE, PJ .
AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY, 1991, 4 (01) :26-32
[3]  
Anie K., 1997, European Respiratory Journal Supplement, V10, p148S
[4]   ANTIBIOTIC-THERAPY IN EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY-DISEASE [J].
ANTHONISEN, NR ;
MANFREDA, J ;
WARREN, CPW ;
HERSHFIELD, ES ;
HARDING, GKM ;
NELSON, NA .
ANNALS OF INTERNAL MEDICINE, 1987, 106 (02) :196-204
[5]  
ARASON VA, 1996, BMJ-BRIT MED J, V313, P389
[6]   QUANTITATIVE SPUTUM GRAM STAINS IN CHRONIC BRONCHIAL DISEASE [J].
BAIGELMAN, W ;
CHODOSH, S ;
PIZZUTO, D ;
SADOW, T .
LUNG, 1979, 156 (04) :265-270
[7]  
BALGOS AA, 1998, MED PROGR, V25, P29
[8]  
BALL P, 1995, PRESSE MED, V24, P189
[9]   Quinolone-induced QT interval prolongation: a not-so-unexpected class effect [J].
Ball, P .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2000, 45 (05) :557-559
[10]  
Ball P, 2000, Semin Respir Infect, V15, P82