莫西沙星序贯治疗老年社区获得性肺炎临床研究

目的:研究莫西沙星序贯治疗老年社区获得性肺炎的的临床疗效、安全性。方法:184例轻中度老年社区获得性肺炎患者随机分为3组。A组(对照组)仅予莫西沙星静脉滴注治疗;B组予莫西沙星序贯治疗;C组予头孢呋辛 阿奇霉素常规序贯治疗。结果:①A组、B组和C组痊愈率分别为67.2%(41/61)、65.5%(38/58)和44.7%(31/65),临床有效率分别为93.4%(57/61)、87.9%(51/58)和72.3%(47/65),细菌清除率分别为88.5%(23/26)、85.2%(23/27)和60.0%(15/25);这3个指标中,A、B两组间差异均无统计学意义,B、C两组间差异均有统计学意义;②B组和C组序贯转换时间窗分别为(2.2±1.1)天、(3.1±1.2)天,两组间差异有统计学意义:③A、B、C组不良反应发生率分别为4.9%(3/61)、3.4%(2/58)和13.8%(9/65),A、B两组间差异均无统计学意义,B、C两组间差异均有统计学意义。结论:莫西沙星序贯治疗老年社区获得性肺炎效果确切、安全。

Sequential moxifloxacin therapy in the treatment of elderly patients with community-acquired pneumonia:clinical evaluation

Objective:To evaluate the efficacy and safety of sequential moxifloxacin therapy in the treatment of elderly patients with community-acquired pneumonia. Methods:One hundred and eighty-four elderly patients with community-acquired pneumonia were randomly divided into three groups. In group A(control group),moxifloxacin was administered by intravenous infusion,400 mg/250 ml once daily for 7~10 d. In group B(moxifloxacin sequential group),moxifloxacin was administered by intravenous infusion 400 mg/250 ml,once daily until to sequential switch time window,followed by oral administration at the same dose. The total treatment duration was also 7~10 days. In group C(combination sequential group),Cefuroxime was administered by intravenous infusion 3.0 g/250 ml,twice daily,with Azithromycin 500 mg/250 ml,once daily until to sequential switch time window,followed by oral administration of Cefuroxime tablet 250 mg,twice daily and Azithromycin table 500 mg,once daily. The total treatment duration was also 7~10 d. Results:The overall cure rates and efficacy rates were 67.2 % and 93.4 % in group A,65.5 % and 87.9 % in group B,44.7 % and 72.3% in group C,respectively. The bacterial clearance rates were 88.5 % in group A,85.2 % in group B,60.0 % in group C,respectively. There was no significant difference(P > 0.05) between group A and B,and there was significant difference(P < 0.05) between group B and C in the above results. Sequential switch time window were(2.2 ± 1.10)d in group B,(3.09 ± 1.23)d in group C,respectively(P < 0.05). The incidence of adverse drug reactions of three groups were 4. 9%,3.4 % and 13.8 %,respectively. There was no significant difference(P > 0.05) between group A and B,and there was significant difference(P < 0.05) between group B and C in the above results. Conclusion:Sequential therapy of moxifloxacin in treatment of elderly patients with community-acquired pneumonia was effective and safe.