高剂量左氧氟沙星治疗老年社区获得性肺炎的有效性与安全性观察

左氧氟沙星是第三代氟喹诺酮类抗生素，抗菌谱广，组织分布范围广，生物利用浓度高，是治疗社区获得性肺炎的有效药物。近来已越来越广泛应用于临床。为研究高剂量左氧氟沙星静脉滴注治疗老年社区获得性肺炎的有效性与安全性。我科应用高剂量左氧氟沙星静脉滴注治疗老年社区获得性肺炎患79例，现将临床疗效与安全性观察结果报告如下。[第一段]     

社区获得性肺炎左氧氟沙星序贯疗法的临床评价与成本效果分析

目的 探讨左氧氟沙星序贯疗法治疗社区获得性肺炎的疗效.方法 将社区获得性肺炎有效病例134例分为序贯治疗组(68例)和对照组(66例),序贯治疗组采用左氧氟沙星序贯疗法,对照组采用静脉滴注疗法.结果 2组治愈率比较无显著性差异(P＞0.05),序贯治疗组治疗费用、不良反应均明显低于对照组(P＜0.01或0.05).结论 左氧氟沙星序贯疗法治疗社区获得性肺炎疗效确切,可缩短住院时间,降低医疗费用,减少不良反应发生,使患者依从性提高,是治疗社区获得性肺炎的理想疗法.     

莫西沙星治疗社区获得性肺炎的疗效和安全性观察

目的 观察莫西沙星治疗社区获得性肺炎的临床疗效及安全性.方法 将108例轻申度社区获得性肺炎患者随机分成治疗组58例和对照组52例,两组分别给予莫西沙星口服和左氧氟沙星静脉点滴治疗.结果 莫西沙星组较左氧氟沙星组无论在总有效率还是痊愈率以及安全性方面均有显著优势.结论 莫西沙星治疗轻中度社区获得性肺炎的临床疗效确切,安全性高.     

左氧氟沙星治疗社区获得性肺炎60例临床分析

目的评价左氧氟沙星治疗社区获得性肺炎的疗效。方法对60例社区获得性肺炎患者，口服左氧氟沙星每次0．5g，每天1次，疗程为7～14d。结果临床有效率为88．2％，细菌清除率为88．5％，药物不良反应发生率为8．3％。结论左氧象沙星治疗社区获得性肺炎安全有效，并能降低医疗费用和不良反应，值得临床推广。     

左氧氟沙星治疗成人社区获得性肺炎的临床疗效

左氧氟沙星是近年来在临床上广泛应用的第3代喹诺酮类药物,其抗菌活性为氧氟沙星的2倍,几乎能覆盖所有引起社区获得性肺炎的病原体,组织渗透性好,肺组织浓度为血药浓度的2～3倍,故有"呼吸道喹诺酮"之称[1]。2010年9月～2012年6月,我们应用左氧氟沙星治疗成人社区获得性肺炎患者33例,效果良好。     

莫西沙星与左氧氟沙星治疗社区获得性肺炎的临床研究

目的探讨莫西沙星和左氧氟沙星治疗社区获得性肺炎的疗效。方法选择社区获得性肺炎患者120例,随机分成莫西沙星组60例和左氧氟沙星组60例,分别给予治疗7 d,运用药物经济学的成本-效果分析方法进行评价。结果莫西沙星组和左氧氟沙星组治疗有效率分别为98.33%和71.67%,细菌清除率分别为91.67和65.57%,不良反应发生率分别为8.33%和13.33%,成本-效果比分别为21.87%和10.26%。结论莫西沙星组的治疗有效率和细菌清除率明显优于左氧氟沙星组（P〈0.01）,莫西沙星治疗社区获得性肺炎在临床治疗中是优选方案。     

痰热清注射液联合左氧氟沙星治疗社区获得性肺炎的临床疗效观察

目的观察痰热清注射液联合左氧氟沙星治疗社区获得性肺炎的临床疗效。方法选取2014年2月—2015年11月开县安康医院收治的社区获得性肺炎患者92例,根据入院时间分为对照组和观察组,每组46例。对照组患者给予左氧氟沙星静脉滴注,观察组患者在对照组治疗基础上给予痰热清注射液静脉滴注;两组患者均连续治疗2个疗程(7 d为1个疗程)。比较两组患者临床疗效,发热、咳嗽、啰音消失时间,炎症病灶吸收情况及发热评分。结果观察组患者临床疗效优于对照组(P0.05)。观察组患者发热、咳嗽、啰音消失时间短于对照组,炎症病灶吸收率高于对照组,发热评分优于对照组(P0.05)。结论痰热清注射液联合左氧氟沙星治疗社区获得性肺炎的临床疗效确切,可快速、有效缓解患者临床症状。     

莫西沙星治疗老年社区获得性肺炎中的疗效

目的评估莫西沙星治疗老年社区获得性肺炎的有效性及其安全性。方法将2008年1月至2009年3月在我科住院的老年社区获得性肺炎分治疗组和对照组,其中治疗组随机抽取40例患者,对照组随机抽取20例患者。治疗组给予莫西沙星400 mg静脉滴注qd;对照组给予左氧氟沙星300 mg静脉滴注qd,疗程为2周。观察临床疗效及其不良反应。结果治疗组有效率87.50%,细菌清除率为82.75%,不良反应12.50%。结论莫西沙星在老年社区获得性肺炎中有效率高,不良反应少。     

左氧氟沙星治疗社区获得性呼吸道感染160例疗效观察

社区获得性呼吸道感染是社区获得性肺炎与慢性支气管炎(慢支)急性发作的总称。2002年11月至2004年12月,我们应用左氧氟沙星治疗社区获得性呼吸道感染160例,取得明显效果。现报告如下。     

左氧氟沙星序贯疗法应用于老年2型糖尿病并社区获得性肺炎患者中的效果分析

目的探讨左氧氟沙星序贯疗法应用于老年2型糖尿病并社区获得性肺炎患者中的效果。方法选择2018年6月—2019年6月该院收治的老年2型糖尿病并社区获得性肺炎患者202例,以随机数表法将其分为对照组与研究组,各101例。在常规对症治疗的基础上,研究组应用左氧氟沙星序贯疗法,对照组应用阿奇霉素序贯治疗。观察两组患者临床疗效、治疗前后血糖指标变化、不良反应情况。结果研究组治疗的总有效率96.04%,高于对照组87.13%,差异有统计学意义(P0.05)。两组治疗前与治疗后空腹血糖、餐后2 h血糖指标对比差异无统计学意义(P0.05)。两组不良反应发生率对比差异无统计学意义(P0.05)。结论左氧氟沙星序贯疗法在老年2型糖尿病并社区获得性肺炎患者中具有显著的应用效果,值得临床推广。     

司帕沙星与氧氟沙星随机对照治疗细菌性感染的临床研究

目的 评价司帕沙星治疗细菌性感染的有效性与安全性。方法 采用多中心随机对照方法,并选用氧氟沙星作为对照。两组共治疗各种感染患者２１２例,其中司帕沙星组１０６例,氧氟沙星组１０６例,均为口服片剂。结果 司帕沙星组与氧氟沙星组痊愈率分别为７４．５％和６９．８％,有效率分别为９１．５％和８８．７％,细菌清除率分别为９０．７％和９０．８％,不良反应发生率分别为９．４３％和８．４９％,以上结果经统计学处理差     

Comparison of cefotaxime and ofloxacin in treatment of spontaneous bacterial peritonitis.

BACKGROUND/AIMS: Gold-standard treatment of spontaneous bacterial peritonitis currently involves 3rd generation cephalosporins. To evaluate the efficacy of ofloxacin in this infection, we compared a combined therapy with intravenous and oral ofloxacin to intravenous cefotaxime. METHODS: Thirty cirrhotic patients with spontaneous bacterial peritonitis were assigned to receive either intravenous (1 g/12 h) cefotaxime for 7 days (n=17) or intravenous (200 mg/12 h) ofloxacin for 2 days followed by oral (200 mg/12 h) ofloxacin for 5 days (n=13). All cases had community-acquired spontaneous bacterial peritonitis. RESULTS: The infection resolution rate on the 7th day of therapy was 82.4% in the cefotaxime group and 92.3% in the ofloxacin group. Hospital survival rates were 82.4% and 100%, respectively. CONCLUSIONS: Oral ofloxacin after a short course of intravenous ofloxacin is effective in the treatment of uncomplicated spontaneous bacterial peritonitis. This regimen may allow physicians to treat these patients as outpatients as soon as their intravenous therapy is completed.     

Effects of combination therapy with interferon and ofloxacin on chronic type C hepatitis: A pilot study

Interferon is effective in only a limited number of patients with the 1b type of hepatitis C virus (HCV), indicating that a combination therapy with other antiviral drugs may be essential to obtain better results. In the present pilot study, the effects of a combination therapy with interferon (IFN) and an antibacterial drug, ofloxacin, were analysed. Ten patients with chronic type C hepatitis received the combination therapy (combination group). Six million units of natural IFN-α were administered daily for 3 weeks and then three times a week for 21 weeks. The combination therapy was initiated at the beginning of the eighth week of IFN treatment and 600 mg ofloxacin per day was administered for 12 weeks. As a control, changes in HCV-RNA were also analysed in patients who were treated with only IFN for the same period (IFN-alone group). In the combination group, serum transaminase levels and the titres of HCV decreased significantly with ofloxacin administration. Such changes were not observed in the IFN-alone group. The incidence of HCV-negativity at the end of ofloxacin administration of the combination group was significantly higher than in the IFN-alone group. The complete response rate was twice as high in the combination group as in the IFN-alone group. In two patients who did not respond well to the IFN-alone treatment, ofloxacin administration was commenced after the 24th week. Serum transaminase levels were normalized and HCV-RNA became negative in these two patients after the administration of ofloxacin. These results suggest that combination therapy with IFN and ofloxacin may be an effective treatment for chronic type C hepatitis.     

Long-term prognosis of patients with ulcerative colitis treated with cytapheresis therapy

BackgroundAlthough accumulating studies in Japan show that cytapheresis (CAP) therapy is safe and effective for the induction of remission of moderate or severe ulcerative colitis (UC), the long-term prognosis of UC patients treated with CAP is unknown. The aim of this study was to determine the long-term prognosis of UC patients treated with CAP.MethodsNinety patients treated previously with CAP and followed for more than 3 years were evaluated. The rates of operation, readmission, and use or dose-up of corticosteroid were analyzed as long-term prognosis.ResultsFollowing the first course of CAP treatment, 64% of patients showed clinical improvement (> 4-point decrease in the clinical activity index (CAI)), and 49% of patients achieved clinical remission (CAI ≤ 4). Longer disease duration and lower age at the first CAP treatment correlated significantly with the therapeutic effects of CAP (p = 0.003 and 0.035, respectively). The rates of operation and readmission were significantly lower in patients who showed previous clinical effects of CAP than in those who did not respond to CAP. The rates of operation and readmission were also significantly lower in patients whose treatment was combined with immunomodulators after the initiation of CAP than in patients who did not use immunomodulators. Importantly, the second course of CAP was also effective in most of the patients who showed a clinical response to the first CAP.ConclusionsPatients who achieve remission after the first CAP therapy may have a good long-term prognosis and a good response to a second CAP therapy even after relapse.     

Increased resistance to ciprofloxacin and ofloxacin in multidrug-resistant mycobacterium tuberculosis isolates from patients seen at a tertiary hospital in the Philippines.

SETTING: A hospital-based study at the Makati Medical Center, Makati City, Philippines, a hyperendemic area for tuberculosis (TB). OBJECTIVE: To determine the susceptibility of Mycobacterium tuberculosis to ciprofloxacin and ofloxacin. DESIGN: Retrospective analysis of drug susceptibility tests (DST) of M. tuberculosis isolated from 1995-2000. RESULTS: Resistance to ciprofloxacin was 26.8%, ofloxacin 35.3%, and multidrug resistance (MDR) was 17.2%. Of the MDR strains, 51.4% were resistant to ciprofloxacin and ofloxacin. Acquired resistance was significantly higher for all first-line drugs and for ciprofloxacin, but not for ofloxacin. A significant increase in resistance to ciprofloxacin and ofloxacin was noted compared to 1989-1994, while resistance to the firstline drugs was not significantly different. CONCLUSION: Ciprofloxacin and ofloxacin are now a significantly less effective alternative therapy in tuberculosis, particularly MDR-TB, due to a selection pressure from their widespread use in the treatment of TB and possibly other infections in the community, which is hyperendemic for tuberculosis.     

Ofloxacin for the treatment of leprosy

Among the major commercially available fluoroquinolones, ciprofloxacin was inactive against M. leprae in mice; pefloxacin was active, 50 mg/kg daily showed bacteriostatic activity but 150 mg/kg daily displayed bactericidal activity; ofloxacin was more active than pefloxacin, 50 mg/kg daily exerted the same level of bactericidal effect as pefloxacin 150 mg/kg daily, and ofloxacin 150 mg/kg displayed profound killing activity. Two clinical trials with 6 months of pefloxacin and/or ofloxacin in 31 previously untreated lepromatous patients have been completed. Pefloxacin 400 mg twice daily or 800 mg once daily or ofloxacin 400 mg once daily were equally effective; definite clinical improvement with drastically decrease of morphological index to the baseline were observed in all patients at 2 months after beginning of treatment; about 99.99%, or 4 "logs", of organisms viable on Day 0 were killed by 22 doses of either pefloxacin or ofloxacin. The side effects from the two trials were rare and mild, and the patients tolerated extremely well the combinations of pefloxacin/ofloxacin plus multidrug therapy (MDT) regimen for multibacillary leprosy recommended by WHO. The amount of rifampicin-resistant mutants in lepromatous patients before treatment are no more than 4 "logs", thus, all rifampicin-resistant mutants may be eliminated by 22 doses of either pefloxacin or ofloxacin. It is, therefore, possible that the combination of ofloxacin and rifampicin may considerably shorten the required duration of MDT.     

TNF-α和sTREM-1对老年社区获得性肺炎初始治疗效果的评价

目的评价动态监测肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和可溶性髓系细胞触发受体-1(soluble trig-gering receptor expressed on myeloid cells-1,sTREM-1)对于判断老年社区获得性肺炎(community-acquired pneumonia,CAP)患者初始治疗效果的作用。方法选取首都医科大学宣武医院急诊病房收治的79例老年CAP患者。根据治疗效果分为治疗有效组和无效组,分别比较两组患者入院时和入院第4d的sTREM-1和TNF-α水平的变化和区别。结果入院时TNF-α和sTREM-1在治疗有效组与无效组比较无显著性差异,治疗有效组TNF-α和sTREM-1在治疗后显著下降(P<0.01),而无效组治疗前后比较则无统计学差异(P>0.05)。结论动态监测sTREM-1和TNF-α的变化有助于判断老年CAP患者的初始治疗效果,TNF-α和TREM-1降低提示治疗有效。     

Efficacy of azithromycin as the empiric therapy in children with community-acquired pneumonia who were isolated macrolide resistant Streptococcus pneumoniae from nasopharynx

Identification of pathogens in childhood community-acquired pneumonia (CAP) is not easy. However, it is believed that nasopharyngeal colonization of pathogenic bacteria leads to childhood CAP, so the etiology is inferred by the isolates obtained from nasopharynx of children with CAP. Among the pathogens of childhood CAP, Streptococcus pneumoniae (SP) is the most important agent and macrolides resistant SP (MRSP) is increasingly reported. We investigated the characterization of the mechanism of macrolide resistance in isolates of MRSP by the presence of the ermB gene or the mefA gene and clindamycin (CLDM) resistance. In addition, we also assessed the efficacy of azithromycin (AZM) in children with CAP who were isolated MRSP from nasopharynx. During a 6 month period between January and June in 2002, children with CAP who were treated with a 3 day regimen of AZM and isolated SP from nasopharynx were enrolled. Clinical outcome was based on assessment of fever on the fourth day of treatment. MIC measurements were obtained by broth microdilution and interpreted according to NCCLS criteria. 53 patients were enrolled and MRSP were isolated in 41 children. Of 41 MRSP isolates, 25 isolates were identified CLDM resistance. The AZM MIC90 of CLDM resistant MRSP isolates was 128 microg/ml. On the other hand, that of CLDM sensitive MRSP isolates was 8 microg/ml. However, AZM was effective in 20 children isolated CLDM resistant MRSP and 15 out of 16 children isolated CLDM sensitive MRSP. On this background, despite high rates of MRSP in Japan, AZM continues to be clinically effective for the treatment of childhood CAP.     

左氧氟沙星治疗老年社区获得性肺炎34例临床分析

目的探讨老年社区获得性肺炎（CAP）经验性治疗的最佳方案。方法选择老年CAP患者68例,随机分为左氧氟沙星组（治疗组）和头孢噻肟组（对照组）各34例,其中,左氧氟沙星组400mg每天一次静滴,头孢噻肟6g／a,分二次静滴,总疗程均为10-14天。结果治疗组有效率91％明显高于对照组的71％（P〈0.05）,治疗组细菌清除率88％,也明显高于对照组的63％（P〈0.05）。结论左氧氟沙星400mg,每天一次静滴,治疗老年性CAP疗效好,不良反应轻,患者可以耐受,且一天一次给药,治疗方便、经济。     

A randomized trial of short-course ciprofloxacin, ofloxacin, or trimethoprim/sulfamethoxazole for the treatment of acute urinary tract infection in women. Ciprofloxacin Urinary Tract Infection Group

PURPOSE: Bladder infections are very common in otherwise healthy women, and short-course antimicrobial treatment appears effective for many episodes of cystitis. This study reports the results of short-course ciprofloxacin, ofloxacin, and trimethoprim/sulfamethoxazole therapy. PATIENTS AND METHODS: We performed a randomized, double-blind study of the efficacy and safety of a 3-day course of oral ciprofloxacin 100 mg twice daily, ofloxacin 200 mg twice daily, or trimethoprim/sulfamethoxazole 160/800 mg twice daily in women with acute, uncomplicated, symptomatic lower urinary tract infection. RESULTS: A total of 866 patients were enrolled, of whom 688 (79%) were evaluated for the efficacy of treatment (229 treated with ciprofloxacin, 228 treated with trimethoprim/sulfamethoxazole, and 231 treated with ofloxacin). The most frequent reason for exclusion was the failure to identify a pretreatment pathogen. The most commonly isolated pathogen was Escherichia coli (81%). Eradication of the pretreatment pathogen at the end of therapy occurred in 94% of ciprofloxacin, 93% of trimethoprim/sulfamethoxazole, and 97% of ofloxacin-treated patients. At follow-up evaluation at 4 to 6 weeks, recurrence rates (relapse or reinfection) were 11% in the ciprofloxacin, 16% in the trimethoprim/sulfamethoxazole, and 13% in the ofloxacin treatment group. Clinical success at the end of therapy was 93% in the ciprofloxacin, 95% in the trimethoprim/sulfamethoxazole, and 96% in the ofloxacin treatment groups. The frequency of all adverse events was 31% for ciprofloxacin, 41% for trimethoprim/sulfamethoxazole, and 39% for ofloxacin-treated patients (P = 0.03). Premature discontinuation of study drug due to an adverse event was more common in trimethoprim/sulfamethoxazole-treated patients (n = 9) compared with those given ciprofloxacin (n = 2) or ofloxacin (n = 1; P = 0.02). CONCLUSION: Ciprofloxacin, ofloxacin, and trimethoprim/sulfamethoxazole had similar efficacy when given for 3 days to treat acute, symptomatic, uncomplicated lower urinary tract infection in women.