阿奇霉素有关物质测定方法的优化分析

目的采用色谱分析法对阿奇霉素相关物质的进行测定,探讨测定方法的优化。方法采用相色谱系统仪器、岛津Class-10Avp系统完成测定,色谱柱为SHISEIDO CAPCELL PAK C18 MG,规格为5μm,250mm×4.6mm。流动相为磷盐酸缓冲液,以0.05mol/L的磷酸氢二钾溶液,以浓度为20%的磷酸调节,直至pH值为8.2;色谱纯试剂乙腈为45∶55;色谱柱温度为30℃;流速为每分钟10mL;检测波长为210nm;进样量为50μL。结果溶液浓度为10~1000μg/mL的范围内的线性关系,结果表明线性关系良好。方法的最低检出限为100ng,r=0.9999。结论本次研究所采用的测定方法能够有效测定阿奇霉素中的相关物质,具有良好的分离性与浓度峰面线性关系。     

小儿支气管肺炎采用痰热清联合阿奇霉素治疗的临床观察

目的探讨小儿支气管肺炎采用痰热清联合阿奇霉素治疗的临床价值。方法将近年来收治的70名小儿支气管肺炎患儿随机分组后分别给予不同治疗方案,观察两组患儿治疗前后症状积分变化情况、临床治疗效果和不良反应。结果 观察组治疗后症状积分改善情况优于参考组(P0.05);观察组治疗总有效率大于参考组(P0.05);两组患者不良反应发生率比较无统计学意义(P0.05)。结论 痰热清联合阿奇霉素治疗小儿支气管肺炎效果确切,安全性高。     

阿奇霉素治疗小儿细菌性痢疾的疗效分析

目的观察和分析阿奇霉素治疗小儿急性细菌性腹泻病的疗效。方法选取2013年1—10月本院儿科收住院的急性细菌性痢疾患儿84例,随机分为两组,治疗组和对照组。治疗组口服阿剂霉素,10mg·kg-1·d-1,1次/d,连续服用3d;对照组口服盐酸头孢他美酯,20mg·kg-1·d-1。结果治疗组的总有效率为97.62%（41/42）,对照组的总有效率为95.24%（40/42）,两组比较差异无统计学意义（P〉0.05）。结论阿奇霉素治疗小儿急性细菌性腹泻病效果理想,安全性高,且给药方便。     

阿奇霉素序贯疗法治疗小儿支原体肺炎的疗效及安全性分析

目的：评价阿奇霉素序贯疗法用于小儿支原体肺炎治疗的疗效及安全性。方法选取2012年4月-2013年6月间于我院呼吸科就诊治疗的肺炎支原体感染患儿134例，按照治疗方式差异分为观察组和对照组，分别采用阿奇霉素序贯疗法及静脉滴注红霉素进行治疗，对比分析两组患儿的临床效果及不良反应发生情况。结果经14 d治疗后，观察组的治疗有效率为95.71%，较对照组（79.69%）显著升高（P〈0.05）；观察组患儿咳嗽、发热、肺部湿啰音消失时间及住院时间均显著缩短（P〈0.05）；同时，观察组的关节疼痛、皮疹、胃肠道反应、血清谷丙转氨酶升高的发生率均显著低于对照组（P〈0.05）。结论采用阿奇霉素序贯疗法治疗小儿支原体肺炎，具有良好的临床疗效，显著缩短患儿的症状消失时间及住院时间，且毒副作用小，值得在临床广泛使用。     

肺炎支原体性肺炎患儿采用红霉素与阿奇霉素治疗对血清TNF-α的影响

目的：探讨肺炎支原体性肺炎患儿采用红霉素与阿奇霉素治疗对血清肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）水平的影响。方法从该院2013年9月—2014年9月收治的肺炎支原体性肺炎患儿中随机选择77例进行研究,按治疗方法分为对照组（38例）和观察组（39例）,分别给予红霉素治疗和阿奇霉素治疗。观察两组的治疗效果和治疗前后的TNF-α水平变化情况,并进行分析。结果观察组的治疗总有效率显著高于对照组,两组的TNF-α水平治疗前比较差异无统计学意义,两组的TNF-α水平治疗后比较差异有统计学意义,观察组显著低于对照组（P＜0.05）。结论利用阿奇霉素治疗肺炎支原体性肺炎患儿可以获得良好的效果,并有效降低其血清TNF-α水平。     

阿奇霉素眼用即型凝胶含量及有关物质的测定方法

目的：建立阿奇霉素眼用即型凝胶含量及有关物质的高效液相色谱检测方法。方法采用 Kromasil C8色谱柱（250mm ×4．6mm,5μm）,流动相为乙腈－磷酸盐缓冲液（50∶50）,流速为1．0mL? min －1,检测波长210nm。结果阿奇霉素与其相邻杂质峰能完全分离,在0．4～1．6mg? mL －1范围内线性关系良好（r＝0．9998）;平均回收率（n＝9）为99．3％。结论所提出的检测方法操作简便、专属性强、结果准确可靠,可用于该制剂的质量控制。     

头孢唑肟联合阿奇霉素治疗社区获得性肺炎的疗效观察

目的：探讨头孢唑肟联合阿奇霉素治疗社区获得性肺炎的临床疗效。方法选取66例社区获得性肺炎患者,随机分为治疗组和对照组,治疗组采用头孢唑肟联合阿奇霉素静滴,对照组单用头孢唑肟静滴,比较2组的临床疗效。结果治疗组和对照组总有效率分别为96.97%,75.75%,2组比较差异有统计学意义（P<0.05）。结论头孢唑肟联合阿奇霉素治疗社区获得性肺炎疗效较好,值得推广应用。     

Antimicrobial resistance pattern and in vivo activity of azithromycin in Salmonella isolates

We evaluated antimicrobial susceptibility pattern of 42 Salmonella isolates from February 2012 through January 2013. We also determined the minimum inhibitory concentrations (MICs) of azithromycin against Salmonella isolates and compared them with corresponding disc diffusion sizes. Entire 42 isolates were sensitive to chloramphenicol, 41 (97.6%) were sensitive to cotrimoxazole and amoxicillin each. MICs for azithromycin ranged from 2 μg/ml to 24 μg/ml, corresponding zone diameters ranged from 15 mm to 33 mm and the two were significantly correlated (P = 0.001). Our results indicate that whereas, azithromycin is a potential therapeutic option, the sensitivity to the first line drugs and absence of multidrug resistance reinforce the concept of antimicrobial recycling.     

阿奇霉素对比阿莫西林/克拉维酸治疗儿童急性中耳炎疗效和安全性的Meta分析

目的采用Meta分析方法比较阿奇霉素与阿莫西林／克拉维酸治疗儿童急性中耳炎疗效和安全性。方法电子检索中国生物医学文献数据库、中文科技期刊数据库、中国知网、万方数据库、中国医学会数字化期刊、PubMed、Cochrane Library和EMBASE数据库,检索起止时间均从建库至2013年8月。纳入阿奇霉素对比阿莫西林／克拉维酸治疗儿童急性中耳炎的RCT文献,对文献进行质量评价。评估临床治愈率、治疗失败率和不良反应。采用RevMan5．0软件进行数据分析,二分类变量采用OR及其95％CI表示。结果共纳入13篇RCT文献（5081例患儿）。Meta分析结果显示,阿奇霉素组与阿莫西St,／克拉维酸组在〈10d临床治愈率（OR=0．69,95％CI：0．46～1．02）、-19d临床治愈率（OR=0．88,95％CI：0．68～1．13）、～29d临床治愈率（OR=0．99,95％CI：0．83—1．19）、t〉30d临床治愈率（OR=1．00,95％CI：0．72～1．39）和治疗失败率（OR=0．87,95％CI：0．65～1．17）差异均无统计学意义。阿奇霉素组恶心（OR=0．44,95％CI：0．20～0．97）、皮疹（OR=0．48,95％CI：0．31～0．75）、腹泻（OR=0．38,95％CI：0．25～0．57）和稀便（OR=0．41,95％CI：0．20—0．81）的发生率显著低于阿莫西林／克拉维酸组。结论阿奇霉素与阿莫西林／克拉维酸治疗儿童中耳炎疗效相当且不良反应少。     

Mass drug administration with azithromycin for trachoma elimination and the population structure of Streptococcus pneumoniae in the nasopharynx

ObjectiveMass drug administration (MDA) with azithromycin for trachoma elimination reduces nasopharyngeal carriage of Streptococcus pneumoniae in the short term. We evaluated S. pneumoniae carried in the nasopharynx before and after a round of azithromycin MDA to determine whether MDA was associated with changes in pneumococcal population structure and resistance.MethodsWe analysed 514 pneumococcal whole genomes randomly selected from nasopharyngeal samples collected in two Gambian villages that received three annual rounds of MDA for trachoma elimination. The 514 samples represented 293 participants, of which 75% were children aged 0–9 years, isolated during three cross-sectional surveys (CSSs) conducted before the third round of MDA (CSS-1) and at 1 (CSS-2) and 6 (CSS-3) months after MDA. Bayesian Analysis of Population Structure (BAPS) was used to cluster related isolates by capturing variation in the core genome. Serotype and multilocus sequence type were inferred from the genotype. Antimicrobial resistance determinants were identified from assemblies, including known macrolide resistance genes.ResultsTwenty-seven BAPS clusters were assigned. These consisted of 81 sequence types (STs). Two BAPS clusters not observed in CSS-1 (n = 109) or CSS-2 (n = 69), increased in frequency in CSS-3 (n = 126); BAPS20 (8.73%, p 0.016) and BAPS22 (7.14%, p 0.032) but were not associated with antimicrobial resistance. Macrolide resistance within BAPS17 increased after treatment (CSS-1 n = 0/6, CSS-2/3 n = 5/5, p 0.002) and was carried on a mobile transposable element that also conferred resistance to tetracycline.DiscussionLimited changes in pneumococcal population structure were observed after the third round of MDA, suggesting treatment had little effect on the circulating lineages. An increase in macrolide resistance within one BAPS highlights the need for antimicrobial resistance surveillance in treated villages.