%0期刊文章%A Bedi, Pallavi %A Cartlidge, Manjit K. %A Zhang, Yang %A Turnbull, Kim %A Donaldson, Samantha %A Clarke, Andrea %A Crowe, Jane %A Campbell, Kadiga %A Graham, Catriona %A frananguylan, Ruzanna %A Rossi, Adriano G. A Hill，亚当·T·% T缩短静脉抗生素治疗的可行性基于细菌负荷——一个概念证明随机对照试验% D J 2021% R 10.1183/13993003.04388 -2020%欧洲呼吸杂志% P 2004388 % X引入有缺乏证据指导期间静脉抗生素治疗支气管扩张急性加重。目的评价急性加重期根据细菌负荷缩短静脉抗生素注射时间是否可行，治疗14天是否更好。方法招募需要静脉注射抗生素治疗急性加重的患者。随机分为两组，分别接受抗生素治疗14天或细菌负荷引导组(BLGG)。于0/7/10/14/21日检测细菌负荷。BLGG第7天或第10天细菌负荷<106 cfu·mL−1时，第2天停用抗生素。结果使用抗生素14天的47例，BLGG组43例。在BLGG组中，88%的参与者能够在第8天停用抗生素，而在第14天组中，有81%的参与者可能在第8天停用抗生素。第21天和第14天，与BLGG相比，临床改善的增加趋势不显著。然而，整体组数据显示，接受抗生素治疗14天组的中位数(四分位数范围)到下一次加重的时间为27.5(12.5-60)天，在BLGG组的中位数(18-110)天;p = 0.0034。在Cox比例危险模型中，14天发生急性加重的可能性更大(与BLGG相比，危险比(95% CI)1.80 (1.16-2.80)， p=0.009，轻度支气管扩张患者发生急性加重的可能性小于重度支气管扩张患者(风险比0.359 (0.13-0.99)，p=0.048)。结论细菌负荷引导治疗对大多数需要静脉注射抗生素的急性加重是可行的。 There was a non-significant trend for increased clinical improvement by day21 with 14 day antibiotics compared with BLGG but paradoxically there was a prolonged time to next exacerbation in BLGG.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Bedi has nothing to disclose.Conflict of interest: Dr. Cartlidge has nothing to disclose.Conflict of interest: Dr. Zhang has nothing to disclose.Conflict of interest: Dr. Turnbull has nothing to disclose.Conflict of interest: Dr. Donaldson has nothing to disclose.Conflict of interest: Dr. Clarke has nothing to disclose.Conflict of interest: Mrs Crowe has nothing to disclose.Conflict of interest: Mrs Campbell has nothing to disclose.Conflict of interest: Dr. Graham reports grants from scottish office, during the conduct of the study; .Conflict of interest: Dr. Frangulyan has nothing to disclose.Conflict of interest: Prof. Rossi has nothing to disclose.Conflict of interest: Prof. Hill has nothing to disclose. %U //www.qdcxjkg.com/content/erj/early/2021/05/20/13993003.04388-2020.full.pdf