高剂量左氧氟沙星治疗呼吸道感染的临床研究

目的 观察大剂量左氧氟沙星静滴治疗呼吸系统感染的安全性与有效性.方法 对82例呼吸道细菌感染患者,分为高剂量左氧氟沙星(可乐必妥)500mg/天一次静脉滴注的治疗组和常规剂量300mg/次每天两次静脉滴注的对照组,疗程5-14天后进行治疗前后两组问的比较.结果 治疗组和对照组的临床总有效率分别为95.24%和95%,经统计学处理差异无显著性不良反应发生率治疗组和对照组分别为9.5%和7.5%,两组间无统计学意义;但3日症状缓解率差异有统计学意义.结论 高剂量左氧氟沙星治疗呼吸道感染疗效好,副作用较小,不良反应较少,是治疗轻中重度呼吸道感染较理想的药物.     

左氧氟沙星不同剂量对老年患者呼吸道感染的疗效评价

目的:评价左氧氟沙星不同剂量对老年患者呼吸道感染的临床疗效。方法:选取2014年1月—2016年12月间收治的老年呼吸道感染患者80例,采用随机数表法将患者分为对照组40例和观察组40例;对照组患者给予常规剂量左氧氟沙星注射液(200 mg/d)治疗,观察组患者给予高剂量左氧氟沙星注射液(500 mg/d)治疗,比较两组患者治疗的总有效率和不良反应的发生率。结果:观察组患者治疗后的总有效率为97.50%高于对照组为82.50%(P<0.05),不良反应的发生率为10.00%略高于对照组为15.00%(P>0.05),细菌清除率为95.24%高于对照组为70.00%(P<0.05)。结论:高剂量左氧氟沙星注射液用于治疗老年患者呼吸道感染的效果较确切,且用药安全性高,有助于缩短治疗疗程,促进患者康复。     

盐酸左氧氟沙星序贯疗法治疗下呼吸道细菌感染的成本-效果分析

目的:评价盐酸左氧氟沙星序贯疗法治疗下呼吸道细茵感染的临床疗效和经济效果.方法:73例下呼吸道细菌性感染患者随机分为两组,序贯组(A组)37例,采用盐酸左氧氟沙星400mg/d,静脉滴注2d～4d,继之以盐酸左氧氟沙星胶囊400mg/d,口服5d～7d;对照组(B组)36例,采用盐酸左氧氟沙星400mg/d,静脉滴注,疗程7d～11d.治疗结束后进行成本一效果分析.结果:A、B两组痊愈率分别为48.6%和55.6%,有效率分别为86.5%和83.3%,细菌清除率分别为81.8%和82.4%,不良反应发生率分别为5.4%和2.8%;经统计学比较,二组疗效相似(P>O.05),但A组的成本一效果比低于B组.结论:盐酸左氧氟沙星序贯疗法与单纯静脉滴注治疗相比,二者临床疗效相似,但前者显著降低了总医疗费用,值得临床应用推广.     

加替沙星序贯治疗下呼吸道感染疗效评价

目的:评价加替沙星静滴、加替沙星静滴和左氧氟沙星口服序贯治疗下呼吸道感染的疗效和安全性。方法:将256例下呼吸道感染患者随机分为2组,其中对照组应用加替沙星注射液400 mg静滴,qd;序贯组用加替沙星注射液400 mg静滴qd,3 d后改为口服左氧氟沙星片400 mg,qd,疗程均为7～14 d。结果:对照组和序贯组总有效率分别为89.84%与85.94%,细菌清除率分别为95.33%与92.45%,药物不良反应发生率分别为8.59%与7.81%,其结果均无经统计学差异(P>0.05)。结论:加替沙星、左氧氟沙星序贯治疗下呼吸道感染具有与单用加替沙星静滴相似的临床疗效,但比单用依从性好。     

不同剂量左氧氟沙星对高龄下呼吸道感染患者白细胞数的影响

目的：探讨不同剂量的左氧氟沙星注射液（可乐必妥）对80a以上急性下呼吸道感染患者白细胞数的影响。方法：将128例住院治疗的急性下呼吸道感染患者，根据应用可乐必妥的剂量不同分为2组，A组（n=60例）静脉滴注可乐必妥每天500mg，B组（n=68例）静脉滴注可乐必妥每天300mg，疗程均为5～13d，用药前及用药后第3，7天查白细胞数。结果：A组患者治疗后第3，7天白细胞数明显下降且低于B组，组间比较差异有统计学意义（P〈0．05）。白细胞数低于4×10^9·L^-1的患者A组有8例（13．33％），B组1例（1．47％），两组比较差异也有统计学意义（P〈0．05）。结论：高龄下呼吸道感染患者在应用左氧氟沙星时．适当减少剂量．可以减少白细胞数下降的不良反应．对临床治疗有一定的指导意义。     

左氧氟沙星序贯疗法治疗慢性阻塞性肺疾病下呼吸道感染的疗效

目的探讨左氧氟沙星序贯疗法治疗慢性阻塞性肺疾病下呼吸道感染的临床疗效。方法选取慢性阻塞性肺疾病下呼吸道感染患者134例,随机分为观察组和对照组,每组各67例。对照组在常规治疗的基础上,给予头孢哌酮钠舒巴坦钠2g,静脉滴注,滴注时间为30～60min,每隔12h给药1次,疗程10~14d。观察组在常规治疗的基础上,先给予左氧氟沙星注射液0.4g,静脉滴注,qd,连续5~7d,病情好转后改为口服,200mg,bid,总疗程10~14d。比较两组患者的临床疗效及不良反应。结果观察组与对照组总有效率分别为89.55%、76.12%,不良反应发生率分别为2.99%、7.46%%,差异具有统计学意义(P<0.05)。结论左氧氟沙星序贯疗法治疗慢性阻塞性肺疾病下呼吸道感染具有较高的临床有效率,且不良反应发生率轻微,具有较高的安全性,对其临床治疗具有一定的指导意义。     

左氧氟沙星不同给药剂量对下呼吸道感染患者的成本-效果评价

目的:评价左氧氟沙星不同给药剂量对下呼吸道感染患者的成本-效果。方法:选取2013年2月—2014年6月间收治的下呼吸道细菌感染患者76例,将其随机分为对照组和治疗组,每组38例;治疗组患者均给予静脉滴注左氧氟沙星注射液500 mg,qd给药,治疗3 d后改为口服左氧氟沙星500 mg,qd给药,持续治疗7 d;对照组患者仅给予静脉滴注左氧氟沙星注射液500 mg,qd给药,持续治疗10 d;比较两组患者治疗后的临床疗效-成本。结果:治疗组患者治疗后的总有效率为97.37%和细菌清除率为81.58%,对照组患者治疗后的总有效率为94.74%和细菌清除率为86.84%,两组患者用药后不良反应症状均较轻;治疗组患者的治疗成本-效果之比为25.28优于对照组为35.45(P<0.05)。结论:采用左氧氟沙星序贯疗法治疗下呼吸道细菌感染患者的成本-效果比值优于左氧氟沙星普通静脉滴注的疗效的成本-效果比值。     

高剂量左氧氟沙星序贯法治疗呼吸道感染的临床观察

目的观察高剂量左氧氟沙星序贯法治疗呼吸道感染的临床效果。方法将呼吸道感染患者58例随机分为观察组29例和对照组29例。观察组采用左氧氟沙星序贯疗法;对照组先给予头孢他啶后改用阿莫西林/克拉维酸钾治疗。比较2组的治疗效果。结果观察组治愈率与总有效率分别为72.41%和89.66%,对照组分别为68.97%和86.21%,2组差异均无统计学意义（P〉0.05）;2组细菌清除率相比,差异无统计学意义（P〉0.05）。结论高剂量左氧氟沙星序贯治疗呼吸道感染的疗效明显、安全可靠,值得临床推广。     

老年呼吸道感染应用左氧氟沙星注射液治疗的效果及剂量分析

目的:研究不同剂量的左氧氟沙星注射液在治疗老年呼吸道感染中的效果。方法:在某院2015年3月~2017年1月间收治的老年呼吸道感染患者中选出100例随机分组,对照组患者给予常规剂量左氧氟沙星注射液治疗,观察组患者给予高剂量左氧氟沙星注射液治疗,对比两组患者的治疗总有效率、临床症状改善时间等指标值。结果:观察组患者的治疗总有效率100%比对照组的88.0%高,且观察组患者的退热时间、止咳时间、胸片正常时间、肺啰音消失时间均比对照组短,P0.05;观察组患者的不良反应发生率14%略高于对照组的10%,P0.05。结论:高剂量左氧氟沙星注射液治疗老年呼吸道感染效果确切,且安全性高,值得推广应用。     

左氧氟沙星序贯治疗下呼吸道感染的临床评价

目的评价左氧氟沙星序贯治疗下呼吸道感染的临床疗效和安全性。方法下呼吸道感染患者60例随机分为治疗组和对照组,各30例。治疗组给予左氧氟沙星注射液400 mg静脉滴注1次/d,用药3～5 d后,改片剂200 mg口服,2次/d;对照组给予头孢他啶2 g静脉滴注,1次/d,3～5 d后,改阿莫西林/克拉维酸片457 mg口服,2次/d,疗程均为7～14 d。结果治疗组和对照组有效率分别为86.7%和90.0%;细菌清除率分别为83.3%和86.7%;均无严重不良反应,两组间的差异无显著性(P>0.05)。结论左氧氟沙星序贯治疗下呼吸道感染,疗效确切,使用安全,且经济方便,有临床应用价值。     

Levofloxacin: a review of its use in the treatment of bacterial infections in the United States

Levofloxacin (Levaquin) is a fluoroquinolone antibacterial agent with a broad spectrum of activity against Gram-positive and Gram-negative bacteria and atypical respiratory pathogens. It is active against both penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae. The prevalence of S. pneumoniae resistance to levofloxacin is <1% overall in the US.A number of randomised comparative trials in the US have demonstrated the efficacy of levofloxacin in the treatment of infections of the respiratory tract, genitourinary tract, skin and skin structures. Sequential intravenous to oral levofloxacin 750mg once daily for 7-14 days was as effective in the treatment of nosocomial pneumonia as intravenous imipenem/cilastatin 500-1000mg every 6-8 hours followed by oral ciprofloxacin 750mg twice daily in one study. In patients with mild to severe community-acquired pneumonia (CAP), intravenous and/or oral levofloxacin 500mg once daily for 7-14 days achieved clinical and bacteriological response rates similar to those with comparator agents, including amoxicillin/clavulanic acid, clarithromycin, azithromycin, ceftriaxone and/or cefuroxime axetil and gatifloxacin. A recent study indicates that intravenous or oral levofloxacin 750mg once daily for 5 days is as effective as 500mg once daily for 10 days, in the treatment of mild to severe CAP. Exacerbations of chronic bronchitis and acute maxillary sinusitis respond well to treatment with oral levofloxacin 500mg once daily for 7 and 10-14 days, respectively.Oral levofloxacin was as effective as ofloxacin in uncomplicated urinary tract infections and ciprofloxacin or lomefloxacin in complicated urinary tract infections. In men with chronic bacterial prostatitis treated for 28 days, oral levofloxacin 500mg once daily achieved similar clinical and bacteriological response rates to oral ciprofloxacin 500mg twice daily. Uncomplicated skin infections responded well to oral levofloxacin 500mg once daily for 7-10 days, while in complicated skin infections intravenous and/or oral levofloxacin 750mg for 7-14 days was at least as effective as intravenous ticarcillin/clavulanic acid (+/- switch to oral amoxicillin/clavulanic acid) administered for the same duration.Levofloxacin is generally well tolerated, with the most frequently reported adverse events being nausea and diarrhoea; in comparison with some other quinolones it has a low photosensitising potential and clinically significant cardiac and hepatic adverse events are rare. CONCLUSION: Levofloxacin is a broad-spectrum antibacterial agent with activity against a range of Gram-positive and Gram-negative bacteria and atypical organisms. It provides clinical and bacteriological efficacy in a range of infections, including those caused by both penicillin-susceptible and -resistant strains of S. pneumoniae. Levofloxacin is well tolerated, and is associated with few of the phototoxic, cardiac or hepatic adverse events seen with some other quinolones. It also has a pharmacokinetic profile that is compatible with once-daily administration and allows for sequential intravenous to oral therapy. The recent approvals in the US for use in the treatment of nosocomial pneumonia and chronic bacterial prostatitis, and the introduction of a short-course, high-dose regimen for use in CAP, further extend the role of levofloxacin in treating bacterial infections.     

高剂量左氧氟沙星治疗老年下呼吸道感染的疗效分析

目的:评价高剂量左氧氟沙星注射液治疗老年下呼吸道感染的临床疗效及安全性。方法:60例老年下呼吸道细菌感染患者,分为试验组(左氧氟沙星500mg静脉滴注,1次.d-1)与对照组(莫西沙星400mg静脉滴注,1次.d-1),疗程7~14d。结果:试验组与对照组对咳嗽、咳痰、发热、外周血白细胞恢复的有效率均在80.00%以上,临床总有效率分别为90.00%、86.67%,细菌清除率分别为76.92%、81.25%,2组疗效比较差异无统计学意义;药品不良反应发生率分别为16.67%、13.33%,2组间差异无统计学意义。结论:高剂量左氧氟沙星治疗老年下呼吸道感染安全、有效。     

加替沙星与左氧氟沙星治疗呼吸道细菌感染的疗效比较

目的:比较加替沙星与左氧氟沙星治疗敏感性细菌引起的呼吸道感染的疗效与安全性。方法:以左氧氟沙星为对照,在30例受试者中进行了随机双盲、双模拟、平行对照试验。A组15例,每日给予加替沙星4 0 0 m g口服。B组15例,每日给予左氧氟沙星4 0 0 mg口服,治疗7d～14 d。结果:A组患者用药后临床痊愈率10 0 % ,有效率10 0 % ,B组患者用药后临床痊愈率93% ,有效率93%。两组疗效比较,差异无显著性(P>0 .0 5 )。A组与B组的细菌清除率均为10 0 % (P>0 .0 5 ) ,两组不良反应发生率分别为13%与8% (P>0 .0 5 )。结论:加替沙星治疗呼吸道感染疗效及安全性与左氧氟沙星相似。     

静脉大剂量注射左氧氟沙星治疗老年下呼吸道感染的疗效和安全性评价

目的评价大剂量左氧氟沙星静脉注射对中国老年患者下呼吸道感染的临床疗效和安全性。方法纳入我院老年科2005年1月（2005年7月确诊为下呼吸道感染并住院的老年患者44例，随意分为左氧氟沙星试验组（n=24例）和头孢哌酮／舒巴坦对照组（n=20例）。试验组给予左氧氟沙星注射液500mg静脉滴注，每日1次；对照组给予头孢哌酮／舒巴坦2．0g静脉滴注，每日2次。结果试验组与对照组痊愈率分别为67％和55％，有效率分别为88％和85％，均无统计学差异（P〉0．05）；两组均未发现不良反应。结论大剂量左氧氟沙星注射可安全、有效地治疗老年患者下呼吸道感染的抗菌药物。     

乳酸左氧氟沙星治疗老年人下呼吸道感染的临床评价

本文报告乳酸左氧氟沙星治疗老年人下呼吸道感染６０例的临床疗效。下呼吸道感染分别为急性支气管炎,慢性支气管炎发作,肺炎,支气管扩张继发感染和支气哮喘继发感染。每日４００ｇｍ,分２次静脉滴注,疗程７－１４ｄ。痊愈率５５．６％,有效率８８．９％,细菌清除率９０％,不良反应发生率８．２％。提示乳酸左氧氟沙星对老年人下呼吸道感染疗效肯定,特别对系统对难治感染有较好的抗菌效果,不良反应轻,安全性好。     

短疗程高剂量左氧氟沙星治疗慢性阻塞性肺疾病急性加重期的临床疗效和安全性

目的：观察静脉应用左氧氟沙星高剂量750 mg,qd,共5天,与常规剂量500 mg,qd,共10天,治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效和安全性。方法：对60例急性下呼吸道感染患者双盲、随机分为治疗组静脉应用左氧氟沙星高剂量750 mg,qd,共5天（30例）和左氧氟沙星组常规剂量500 mg,qd,共10天（30例）进行治疗。结果：左氧氟沙星高剂量组痊愈20例,显效7例,进步3例,治愈率为66.6%,有效率为90.0%。左氧氟沙星常规剂量组痊愈18例,显效8例,进步3例,无效1例,治愈率为60.0%,总有效率为86.7%。两组总有效率比较差异有统计学意义（P〈0.05）。治疗组细菌总清除率为81.9%,对照组为77.8%,不良反应发生率分别为3.33%和6.66%。结论：短疗程大剂量的左氧氟沙星治疗慢性阻塞性肺疾病急性加重期（AECOPD）疗效好,安全性高。     

加替沙星、左氧氟沙星序贯治疗下呼吸道感染的药物经济学评价

目的：评价加替沙星静脉滴注和加替沙星静脉滴注与左氧氟沙星口服序贯治疗下呼吸道感染的成本-效果,为临床制定合理用药方案提供参考。方法：将256例下呼吸道感染患者随机分为2组,其中对照组应用加替沙星注射液400mg静脉滴注,qd;序贯组用加替沙星注射液400mg静脉滴注qd,3d后改为口服左氧氟沙星片400mg,qd,疗程均为7～14d,观察两组的临床疗效,并进行成本-效果分析。结果：2组在临床疗效、细菌学清除率及不良反应发生率方面差异无统计学意义（P〉0.05）,但对照组的费用却显著高于序贯治疗组（P〈0.05）。结论：加替沙星、左氧氟沙星序贯治疗下呼吸道感染具有与单用加替沙星静脉滴注相似的临床疗效,但比单用更具经济学意义,是治疗下呼吸道感染的经济合理方案。     

Clinical study of levofloxacin 500 mg qd in the treatment of cervicitis and intrauterine infections caused by Chlamydia trachomatis

The clinical efficacy and safety of levofloxacin (LVFX) 500mg qd were evaluated in female patients with cervicitis with Chlamydia trachomatis and intrauterine infections. LVFX was administered orally at 500 mg qd for 7 days. Bacteriological efficacy was 94.4% (17/18) and clinical efficacy was 100% (16/16) at 14 to 21 days after the end of treatment in cervicitis. On the other hand, bacteriological efficacy and clinical efficacy at the end of treatment in intrauterine infections were 68.8% (11/16) and 94.7% (18/19), respectively. For safety, adverse drug reactions occurred in 9 of 43 patients (20.9%), i.e., increased y-GTP in 2 patients, glucose urine present in 2, and each of all other adverse reactions occurred in 1. All adverse drug reactions observed were either mild or moderate. Results suggested that LVFX 500 mg qd was effective and safe in the treatment of cervicitis with Chlamydia trachomatis and intrauterine infections.     

甲磺酸帕珠沙星氯化钠注射液治疗急性细菌性感染多中心临床研究

目的 评价甲磺酸帕珠沙星氯化钠注射液治疗临床常见细菌性感染的安全性和有效性。方法 用随机单盲平行对照多中心同步试验法。甲磺酸帕珠沙星氯化钠注射液(试验组)每次500mg，盐酸左氧氟沙星氯化钠注射液(对照组)每次400mg，均每日1次，静脉滴注，疗程均7～14天。共入选病例251例，其中：试验组122例，临床疗效评价病例115例，安全性评价例数122例；对照组129例，临床疗效评价病例122例，安全性评价例数129例。结果 2组临床总有效率分别为96．5％和98．4％；细菌清除率分别为98．9％和98．0％；药物不良反应发生率分别为11．5％和9．35％。结论 甲磺酸帕珠沙星氯化钠注射液治疗临床常见细菌性感染安全、有效。     

Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia

SUMMARY

Objective: To evaluate the time to symptom resolution and IV-to-PO transition in community-acquired pneumonia (CAP) patients treated with 750?mg or 500?mg levofloxacin.

Research Design: A retrospective, subset analysis of a multicenter, randomized, double-blind, controlled trial comparing 750?mg levofloxacin for 5 days to 500?mg levofloxacin for 10 days for the treatment of CAP.

Patients and Methods: A total of 528 CAP patients were included. Baseline symptoms were re-evaluated on Day 3 of therapy, and time to IV-to-PO transition was recorded for inpatients.

Results: For the overall population, 67.4% of patients receiving 750?mg levofloxacin had resolution of fever by Day 3 of therapy, compared to 54.6% of 500?mg treated patients (?P = 0.006). Patients who started on 750?mg levofloxacin IV (?N = 108) transitioned to PO in an average of 2.68 days while those starting on 500?mg IV (?N = 124) transitioned in 2.95 days (?P = 0.144). The median time for IV-to-PO switch was 2.35 days and 2.75 days for patients receiving 750?mg and 500?mg levofloxacin, respectively (?P = 0.098, log rank test). By Day 3 of therapy, 68% of patients receiving the 750?mg dose had transitioned from IV to PO levofloxacin, compared with 61% of the 500?mg group (?P = 0.280). The safety profiles were comparable for the two regimens.

Conclusions: The 750?mg levofloxacin dose resulted in a greater proportion of patients with resolution of CAP symptoms by Day 3 when compared with 500?mg therapy. Consequently, the 750?mg regimen trended toward more rapid transition to PO, potentially resulting in lower overall drug costs. Time to switch from IV to PO was determined by the investigators’ discretion rather than a set protocol. Additionally, length of stay data was not collected in this study, which can significantly impact overall healthcare costs. Further research is required to fully understand the economic impact of the 750?mg, 5-day levofloxacin regimen.