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Антибактериальная терапия и профилактика обострений хронической обструктивной болезни легких
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Аннотация
В публикации рассматриваются современные подходы к антибактериальной терапии и профилактике обострений хронической обструктивной болезни легких (ХОБЛ). Представлены эпидемиология заболевания, этиология обострений, показания к антибактериальной терапии и тактика назначения антибиотиков с учетом современных клинических рекомендаций. Особое внимание уделено вопросам профилактики инфекционных обострений ХОБЛ, в том числе представлены исследования, посвященные анализу профилактической эффективности бактериальных лизатов у больных ХОБЛ.
Ключевые слова: хроническая обструктивная болезнь легких, обострение, антибактериальная терапия, профилактика.
Ключевые слова: хроническая обструктивная болезнь легких, обострение, антибактериальная терапия, профилактика.
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The article reviews current approaches to antibiotic therapy and prevention of exacerbations of chronic obstructive pulmonary disease (COPD) and presents the epidemiology of the disease, the etiology of exacerbations, indications for antibiotic therapy and tactics antibiotics with current clinical guidelines. Particular attention is paid to the prevention of infectious exacerbations of COPD, including the presented research on the analysis of the prophylactic efficacy of bacterial lysates in patients with COPD.
Key words: chronic obstructive pulmonary disease, exacerbation, antibiotic therapy, prevention.
Полный текст
Список литературы
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16. Sethi S, Murphy T. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 2008; 359: 2355.
17. Murphy T, Parameswaran G. Moraxella catarrhalis, a human respiratory tract pathogen. Clin Infect Dis 2009; 49 (1): 124–31.
18. Diederen B, Van der Valk P, Kluytmans J et al. The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease. Eur Respir J 2007; 30: 240–4.
19. Kherad O, Rutschmann O. Viral Infections as a Cause of Chronic Obstructive Pulmonary Disease (COPD) Exacerbation. Praxis 2010; 99 (4): 235–40.
20. Lode H, Allewelt M, Balk S et al. A prediction model for bacterial etiology in acute exacerbations of COPD. Infection 2007; 35: 143–9.
21. Eller J, Ede A, Schaberg T et al. Infective exacerbations of chronic bronchitis: relation between bacteriologic etiology and lung function. Chest 1998; 113 (6): 1542–8.
22. Anthonisen NR, Manfreda J, Warren CP et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196–204.
23. Зайцев А.А. Обострение ХОБЛ. Практические рекомендации. Фарматека. 2014; 15: 51–7.
24. Wongsurakiat P, Maranetra KN, Wasi C et al. Acute respiratory illness in patients with CORD and the effectiveness of influenza vaccination: a randomized controlled study. Chest 2004; 125 (6): 2011–20.
25. Jackon LA, Neuzil KM, Yu O et al. Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 2003; 348 (18): 1747–55.
26. Furumoto A, Ohkusa Y, Chen M et al. Additive effect of pneumococcal vaccine and influenza vaccine on acute exacerbation in patients with chronic lung disease. Vaccine 2008; 26 (33): 4284–9.
27. Black P, Staykova T, Chacko E et al. Prophylactic antibiotic therapy for chronic bronchitis. Cochrane Database Syst Rev 2003; 1: CD004105.
28. Murphy T, Sethi S. Bacterial infection in chronic obstructive pulmonary disease. Am Respir Dis 1992; 146: 1067–83.
29. Fletcher C, Ball J, Carstairs L et al. Value of chtmoprophylaxis and chemotherapy in early chronic bronchitis. A report to the Medical Research Council by their working party on trials of chemotherapy in early chronic bronchitis. BMJ 1966; 1 (5499): 1317–22.
30. Johnston R, McNeill R, Smith D et al. Five-year winter chemoprophylaxis for chronic bronchitis. Br Med J 1969; 4 (678): 265–9.
31. Albert R, Connett J, Bailey W et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med 2011; 365: 689–98.
32. Cogo R, Ramponi A, Scivoletto G, Rippoli R. Prophylaxis for acute exacerbations of chronic bronchitis using an antibacterial sublingual vaccine obtained through mechanical lysis: a clinical and pharmacoeconomic study. Acta Biomed 2003; 2 (74): 81–7.
33. Cazzola M. A new bacterial lysate protects by reducing infectious exacerbations in moderate to very severe COPD. Trends in medicine 2006; 6 (3): 199–207.
34. Cazzola M, Anapurapu S, Page C. Polyvalent mechanical bacterial lysate for the prevention of recurrent respiratory infections: a meta-analysis. Pulm Pharmacol Ther 2012; 25 (1): 62–8.
2. Чучалин А.Г., Айсанов З.Р., Авдеев С.Н. и др. Федеральные клинические рекомендации по диагностике и лечению хронической обструктивной болезни легких. М., 2014. http://www.pulmonology.ru/publications/guide.php?clear_cache=Y
3. Roche N, Huchon G. Epidemiology of chronic obstructive pulmonary disease. Rev Prat 2004; 54 (13): 1408–13.
4. Fuhrman C, Delmas M. Epidemiology of chronic obstructive pulmonary disease in France. Rev Mal Respir 2010; 27 (2): 160–8.
5. World Health Report 2000. Health systems: improving performance. Annex table 3. 2000 World Health Organization. Geneva, Switzerland.
6. Mapel D, Chen J, George D et al. The cost of chronic obstructive pulmonary disease and its effects on managed care. Manag Care Interface 2004; 17 (4): 61–6.
7. Fein A, Fein AM. Management of acute exacerbations in chronic obstructive pulmonary disease. Curr Opin Pulm Med 2000; 6 (2): 122–26.
8. Donaldson GC, Seemungal T, Bhowmik A et al. The relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847–52.
9. Niewoehner D. Relation of Chronic Obstructive Pulmonary Disease Exacerbations to FEV(1) – An Intricate Tango. Respiration 2009; 77 (2): 229–35.
10. Soler-Cataluña J, Martinez-Garcia M, Sanches L et al. Severe exacerbations and BODE index: two independent risk factors for death in male COPD patients. Respir Med 2009; 103 (5): 692–9.
11. Soler-Cataluña J, Martinez-Garcia M, Roman Sanches P et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005; p. 925–31.
12. O’Donnell D, Parker C. CORD exacerbations: Pathophysiology. Thorax 2002; 57: 847–52.
13. Dusser D. Chronic obstructive pulmonary disease exacerbations and their impact on the long-term natural history of the disease. Presse Med 2008; 37 (11): 1599–603.
14. Синопальников А.И., Козлов Р.С., Романовских А.Г., Рачина С.А. Инфекционное обострение ХОБЛ: практические рекомендации по диагностике, лечению и профилактике. Рос. мед. вести. 2006; 11 (1): 4–18.
15. Sethi S. Bacteria in exacerbations of chronic obstructive pulmonary disease. The Proceedings of the American Thoracic Society 2004; 1: 109–14.
16. Sethi S, Murphy T. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 2008; 359: 2355.
17. Murphy T, Parameswaran G. Moraxella catarrhalis, a human respiratory tract pathogen. Clin Infect Dis 2009; 49 (1): 124–31.
18. Diederen B, Van der Valk P, Kluytmans J et al. The role of atypical respiratory pathogens in exacerbations of chronic obstructive pulmonary disease. Eur Respir J 2007; 30: 240–4.
19. Kherad O, Rutschmann O. Viral Infections as a Cause of Chronic Obstructive Pulmonary Disease (COPD) Exacerbation. Praxis 2010; 99 (4): 235–40.
20. Lode H, Allewelt M, Balk S et al. A prediction model for bacterial etiology in acute exacerbations of COPD. Infection 2007; 35: 143–9.
21. Eller J, Ede A, Schaberg T et al. Infective exacerbations of chronic bronchitis: relation between bacteriologic etiology and lung function. Chest 1998; 113 (6): 1542–8.
22. Anthonisen NR, Manfreda J, Warren CP et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196–204.
23. Зайцев А.А. Обострение ХОБЛ. Практические рекомендации. Фарматека. 2014; 15: 51–7.
24. Wongsurakiat P, Maranetra KN, Wasi C et al. Acute respiratory illness in patients with CORD and the effectiveness of influenza vaccination: a randomized controlled study. Chest 2004; 125 (6): 2011–20.
25. Jackon LA, Neuzil KM, Yu O et al. Effectiveness of pneumococcal polysaccharide vaccine in older adults. N Engl J Med 2003; 348 (18): 1747–55.
26. Furumoto A, Ohkusa Y, Chen M et al. Additive effect of pneumococcal vaccine and influenza vaccine on acute exacerbation in patients with chronic lung disease. Vaccine 2008; 26 (33): 4284–9.
27. Black P, Staykova T, Chacko E et al. Prophylactic antibiotic therapy for chronic bronchitis. Cochrane Database Syst Rev 2003; 1: CD004105.
28. Murphy T, Sethi S. Bacterial infection in chronic obstructive pulmonary disease. Am Respir Dis 1992; 146: 1067–83.
29. Fletcher C, Ball J, Carstairs L et al. Value of chtmoprophylaxis and chemotherapy in early chronic bronchitis. A report to the Medical Research Council by their working party on trials of chemotherapy in early chronic bronchitis. BMJ 1966; 1 (5499): 1317–22.
30. Johnston R, McNeill R, Smith D et al. Five-year winter chemoprophylaxis for chronic bronchitis. Br Med J 1969; 4 (678): 265–9.
31. Albert R, Connett J, Bailey W et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med 2011; 365: 689–98.
32. Cogo R, Ramponi A, Scivoletto G, Rippoli R. Prophylaxis for acute exacerbations of chronic bronchitis using an antibacterial sublingual vaccine obtained through mechanical lysis: a clinical and pharmacoeconomic study. Acta Biomed 2003; 2 (74): 81–7.
33. Cazzola M. A new bacterial lysate protects by reducing infectious exacerbations in moderate to very severe COPD. Trends in medicine 2006; 6 (3): 199–207.
34. Cazzola M, Anapurapu S, Page C. Polyvalent mechanical bacterial lysate for the prevention of recurrent respiratory infections: a meta-analysis. Pulm Pharmacol Ther 2012; 25 (1): 62–8.
Авторы
А.А.Зайцев1, А.И.Синопальников2
1. ФГКУ Главный военный клинический госпиталь им. Н.Н.Бурденко Минобороны России;
2. ГБОУ ДПО РМАПО Минздрава России, Москва
1. ФГКУ Главный военный клинический госпиталь им. Н.Н.Бурденко Минобороны России;
2. ГБОУ ДПО РМАПО Минздрава России, Москва
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A.A.Zaytsev, A.I.Sinopalnikov
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