不同剂量阿奇霉素和左氧氟沙星治疗呼吸道肺炎支原体感染的对照研究

目的探讨阿奇霉素和左氧氟少星快速（2d）治疗呼吸道肺炎支原体（Mp）感染的效果和可行性，为治疗Mp感染提供快捷途径。方法采用随机和对照的方法前瞻性观察随机收治的141例呼吸道Mp感染患者，年龄19～70（平均41．2）岁，分三组（性别、年龄相匹配）。组1，61例，每日予阿奇霉素10mg／kg，1次／d，po，疗程7d。组2，56例，每日子阿奇霉素10mg／kg，1次／d，po；左氧氟沙星200mg，3次／d，疗程5d。组3，24例，每日予阿奇霉素30mg／kg，1次／d，po；左氧氟沙星600mg（体重〈50kg者400mg），3次／d，疗程2d。疗程结束后随访。结果三组完成观察的分别为54、48和22例。组1、2、3，疗程结束后症状消失率分别为88．9％（48／54），91．7％（44／48）和95．5％（21／22）。组3疗效显著快于组1和组2（P〈0．001），组2显著快于组1（P〈0．001）。小于30岁和治疗及时的患者症状消失快于60岁以上（P〈0．05）和未及时治疗的患者。三组均未出现严重不良反应。随访6mo～3a，未发现异常。结论大剂量阿奇霉素和左氧氟沙星联用治疗Mp感染安全方便，起效快，疗程短，清除Mp彻底。

High-dose azithromycin and levofloxacin for respiratory Mycoplasma pneumoniae infection

Objective To investigate the effect and feasibility of high-dose azithromycin and levofloxacin on treating respiratory Mycolasma pneumoniae （Mp） infection. Methods 141 respiratory Mp infected patients with average aged at 41.2 years （ranged 19-70 years） were enrolled and randomized into three groups. Group 1 contained 61 patients and received azithromycin 10 mg/kg, orally, daily for 7 days; Group 2 included 56 subjects and received azithromycin 10 mg/kg, orally, daily, and levofloxacin 200 mg orally, 3 times daily for five days. Group 3 contained 24 subjects and received azithromycin 30 mg/kg, orally, daily and levofloxacin 600 mg （bw. 〈50kg, 400 rag） orally, twice/day for two days. Results 54, 48 and 22 subjects in group l, 2 and 3 completed the follow up visits, respectively. After the last dosage, the symptoms disappeared in 88.9% （48/54）, 91.7% （44/48） and 95.5% （21/22） for group 1, 2 and 3, respectively. Overall, the treatment courses was significantly shorter in group 3 than that in group 1 and 2 （P〈0.001）, and group 2 has shorter treatment than group 1 （P〈0.001）. Subjects 〈 30 years old recovered significantly quicker than those 〉60 years old （P〈0.05）. No severe side-effects were observed in all three groups during the study and subsequent 6-36 months follow-up. Conclusions High-dose azithromycin and levofloxacin for respiratory Mp infection is a safe and effective treatment regimen with a shortened treatment course.