摘要
背景:尽管粘膜炎、腹泻、便秘以及免疫抑制是公认的癌症治疗的副作用,其机制包括肠道菌群组成的变化和艰难梭菌感染却尚未彻底被阐明。 前言:本文查阅相关文献,综述了癌症化疗,放射治疗,和艰难梭菌相关性结肠炎之间的关系。 方法:对2008至2015年之间出版的英文文献,肿瘤化疗、放射治疗联合筛查,和艰难梭菌相关性结肠炎的关系进行综述。 结果:某些化疗的组合,主要是那些含有紫杉醇,更可能是由艰难梭菌感染(CDI)的,而另一些类型的肿瘤更易并发CDI化疗后。CDI照射后大多发生在患者接受治疗的癌症,在头部和颈部区域。风险因素发现质子泵抑制剂、抗生素、抗癌药物、管料。对于中度CDI轻度首次发作的首选药物是甲硝唑,而万古霉素保留严重CDI的初始集。fidaxomycin是重症治疗CDI的另一种选择,以减少复发。 结论:超声对肿瘤患者治疗的影响还没有完全承认。艰难梭菌感染患者抗生素治疗的同时,化疗更频繁。积极的支持性护理,静脉注射水化,抗生素,密切的手术监测选择性干预,可以显着降低发病率和危及生命的并发症与这种感染。
关键词: 难辨梭状芽孢杆菌,抗生素,化疗,放射治疗,靶向治疗,医院腹泻。
Current Medicinal Chemistry
Title:Clostridium difficile Infection: Associations with Chemotherapy, Radiation Therapy, and Targeting Therapy Treatments
Volume: 23 Issue: 39
Author(s): Avi Peretz, Izhar Ben Shlomo, Orna Nitzan, Luigi Bonavina, Pmela M. Schaffer, Moshe Schaffer
Affiliation:
关键词: 难辨梭状芽孢杆菌,抗生素,化疗,放射治疗,靶向治疗,医院腹泻。
摘要: Background: Although mucositis, diarrhea, and constipation as well as immunosuppression are well recognized side-effects of cancer treatment, the underlying mechanisms including changes in the composition of gut microbiota and Clostridium difficile infection have not yet been thoroughly reviewed.
Objective: We herein set out to review the literature regarding the relations between cancer chemotherapy, radiation treatment, and Clostridium difficile-associated colitis.
Method: Review of the English language literature published from 2008 to 2015 on the association between cancer chemotherapy, radiation treatment, and C. difficile-associated colitis.
Results: Certain chemotherapeutic combinations, mainly those containing paclitaxel, are more likely to be followed by C. difficile infection (CDI), while some tumor types are more likely to be complicated by CDI following chemotherapy. CDI following irradiation occurs mostly in patients who were treated for cancer in the head and neck area. Risk factors found were proton pump inhibitors, antibiotics, cytostatic agents, and tube feeding. The drug of choice for an initial episode of mild-to-moderate CDI is metronidazole, whereas vancomycin is reserved for an initial episode of severe CDI. Fidaxomycin is another option for treatment of severe CDI, with fewer recurrences.
Conclusion: The influence of CDI on the treatment of oncological patients is not fully acknowledged. Infection with C. difficile is more frequent in those patients treated by antibiotics simultaneously with chemotherapy. Aggressive supportive care with intravenous hydration, antibiotics, and close surgical monitoring for selective intervention can significantly decrease the morbidity and life-threatening complications associated with this infection.
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Avi Peretz, Izhar Ben Shlomo, Orna Nitzan, Luigi Bonavina, Pmela M. Schaffer, Moshe Schaffer , Clostridium difficile Infection: Associations with Chemotherapy, Radiation Therapy, and Targeting Therapy Treatments, Current Medicinal Chemistry 2016; 23 (39) . https://dx.doi.org/10.2174/0929867323666161028162018
DOI https://dx.doi.org/10.2174/0929867323666161028162018 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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