头孢地嗪的临床及免疫调节作用研究

为评价头孢地嗪治疗免疫缺陷者感染的疗效、安全性及免疫调节作用，在１０７例呼吸道、尿路及其他细菌感染中，与头孢唑肟进行随机对照研究。有效率、痊愈率和细菌清除率头孢地嗪组分别为８７．３％、６１．８％和８９．３％；头孢唑肟组分别为８２．７％、５９．６％和９０．６％。不良反应发生率头孢地嗪组５．２％，头孢唑肟组７．４％。头孢地嗪组治疗后ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值升高，ＮＫ细胞活性增强，活化的淋巴细胞白细胞介素－２受体表达增多，对照药头孢唑肟则无显著作用。研究结果显示，头孢地嗪治疗免疫缺陷者感染安全有效，并具免疫调节作用。     

头孢布烯与头孢呋辛随机对照治疗急性细菌性感染临床评价

目的进一步评价头孢布烯治疗细菌性感染的安全有效性。方法采用随机对照开放试验方法。头孢布烯组２００ｍｇ，口服；头孢呋辛组７５０ｍｇ，静脉点滴；均为每１２小时一次。疗程７～１４天。结果头孢布烯组及头孢呋辛组分别有６６例及６７例可评价疗效，两组有效率分别为８７．９％及８９．６％。本次观察共分离致病菌１１０株，细菌清除率分别为９０７％及８９３％。两组安全性评价分别为６６例及７０例，不良反应发生率分别为１０．６％与１０．０％。两组经统计学处理差异无显著性（Ｐ＞０．０５）。结论采用头孢布烯治疗急性细菌性感染安全、有效     

头孢吡肟与头孢他啶随机对照治疗细菌性感染129例

目的 评价头孢吡肟治疗细菌性感染的疗效和安全性。方法 以头孢他啶为对照药,在下呼吸道感染,腹腔,胆道感染,败血症中进行随机对照观察。给药方案为头孢吡肟每次２ｇ,２次／ｄ,头孢他啶每次２ｇ,３闪／ｄ;治疗尿路感染头孢吡肟每次１ｇ,２次／ｄ,头孢他啶每头１ｇ,３闪／ｄ;均为静脉滴注,疗程均为７－１４ｄ。结果 头孢吡肟组６５例,头孢他啶组６４例。头孢吡肟组和头孢他啶组有效率分别为９２．３％及９０．６％,     

头孢他美匹酯与头孢克肟随机对照治疗细菌性感染的临床研究

为评价头孢他美匹酯的安全性及临床疗效，用头孢他美匹酯（每１２小时２５０～５００ｍｇ）与头孢克肟（每１２小时２００ｍｇ，疗程均为７～１０天）随机对照治疗呼吸道与泌尿道感染９９例。试验组进入临床试验病例６１例，不良反应评价病例５５例，疗效评价５１例。对照组进入试验病例５８例，不良反应评价病例５４例，疗效评价４８例。结果头孢他美匹酯与头孢克肟两组的临床有效率分别为９４．１％（４８／５１例）与９１．７％（４４／４８例），细菌清除率分别为９５．３％与９５．１％，不良反应发生率分别为９．１％与７．４％，上述结果经统计学比较差异无显著性。表明头孢他美匹酯为治疗临床常见的呼吸道、泌尿道感染的安全、有效的抗菌药物。     

青霉烷砜／氨苄青霉素与头孢呋肟序贯疗法对老年呼吸道感染的临床研究

目的本总结青霉烷砜／氨苄青霉素(优立新)与头孢呋肟序贯疗法对老年人急性呼吸道感染治疗的临床疗效。方法对31例呼吸道感染患静脉注射青霉烷砜／氨苄青霉素继服舒他西林(优立新组)；同时对52例患静脉注射头孢呋肟继服头孢呋肟酯(头孢呋肟组)．两组疗效进行比较。结果优立新组：痊愈12例(39％)．显效12例(39％)．总有效率78％；头孢呋肟组：痊愈24例(46％)．显效15例(29％)，总有效率75％；两组在疗程中均无肝、肾、血象等方面的不良反应。结论两种序贯治疗对老年急性呼吸道感染均有较好的疗效．无明显差异。安全性高，使用方便。     

国产头孢吡肟注射液治疗COPD急性加重期合并糖尿病的临床观察

目的评价国产头孢吡肟注射液治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并糖尿病的临床疗效和安全性。方法选择AECOPD合并糖尿病患者60例,每组30例,分别使用头孢吡肟和头孢哌酮治疗,观察两组的有效率和细菌清除率。结果头孢吡肟和头孢哌酮的有效率分别为93．3％、63．3％,细菌清除率分别为93．1％、67．8％,有显著性差异（P〈0．05）。结论国产头孢吡肟治疗AECOPD合并糖尿病安全、有效。     

广州地区奈瑟氏淋球菌对头孢妥仑耐药性的监测与分析

目的 了解广州地区奈瑟氏淋球菌对头孢妥仑的药物敏感性和耐药性。方法 采用琼脂稀释法测定头孢妥仑对分离的耐瑟氏淋球菌的最低抑菌浓度（MIC）。结果 头孢妥仑的MIC90由1993年的0．125mg／L上升至2004年的0．5mg／L，其敏感度下降2个对倍稀释度，而同一时间其它抗菌药MIC值的变化则远远大于该监测数据。该研究中未发现对头孢妥仑的耐药菌株。结论 目前广州地区流行的奈瑟氏淋球菌的耐约情况日趋严重，喹喏酮类药物的高度耐药率表明已不再适宜被推荐为治疗淋病的一线药物。头孢妥仑对奈瑟氏淋球菌仍然处于良好的敏感状态，推荐用于淋病的治疗有良好的临床疗效。但考虑到淋球菌对各种抗生素敏感度的变化，有必要监测奈瑟氏淋球菌的耐药性，减少抗菌药物的滥用，保证药物的敏感性。     

头孢克肟治疗呼吸道感染的临床评价

头孢克肟治疗呼吸道感染的临床评价茅培英，崔德健，文仲光头孢克后是第３代口服头孢菌素，抗菌谱广，对β－内酰胺酶稳定，口服吸收好，血清浓度高且持续时间长，口服后４小时血药浓度达高峰，半衰期２．３～３．５小时￣［１］，小儿３～４小时，组织渗透性强，肺组织、...     

头孢美唑及其他抗生素的抗菌活性分析

为研究头孢美唑和其他４种抗生素的体外抗菌活性，采用美国全国临床检验标准委员会（ＮＣＣＬＳ）推荐的琼脂稀释法测定头孢美唑对４６３株菌的最小抑菌浓度（ＭＩＣ），并与头孢唑啉、头孢呋辛、头孢噻肟、头孢他啶作比较。结果表明，头孢美唑对吲哚阳性的普通变形杆菌和摩根摩根菌活性最高，ＭＩＣ９０为８ｍｇ／Ｌ，其对大肠杆菌、肺炎克氏菌和吲哚阴性的奇异变形杆菌抗菌活性同头孢噻肟，敏感率为８２％～１００％，但略低于头孢他啶（敏感率为８８％～１００％）。头孢美唑对苯唑西林敏感的葡萄球菌也有高活性，其ＭＩＣ９０为４ｍｇ／Ｌ。研究提示，头孢美唑对所研究的大多数肠杆菌科细菌及苯唑西林敏感的葡萄球菌有较高活性。     

典沙注射液与利君特舒存在配伍禁忌

典沙为甲磺酸培氟沙星葡萄糖注射液，为喹诺酮类抗菌药，临床用于敏感细菌引起的尿路感染及呼吸道感染等。利君特舒则为注射用头孢酮钠舒巴坦钠（2：1）。第三代头孢类抗菌药，主要作用也是治疗泌尿系感染、呼吸道感染等。当输完利君特舒组液（5％葡萄糖注射液100ml＋利君特舒1．5g静点）给予更换典沙注射液时输液器茂菲氏滴管内立即出现白色混浊，更换输液器并留置6h后白色浑浊仍未消失。表明：典沙与利君特舒存在配伍禁忌。在临床输液中，如需要同时应用时，两种药物不可直接接触，可用0．9％氯化钠溶液或5％葡萄糖冲管间隔，以避免医疗事故的发生。     

左氧氟沙星治疗4888例细菌性感染的多中心临床研究

目的 评估左氧氟沙星500 mg静脉注射液每日一次治疗细菌性感染的有效性与安全性.方法 多中心、前瞻性、开放性Ⅳ期临床试验.对入选患者给予左氧氟沙星500 mg静脉注射液,1次/d,疗程7～14 d,观察临床疗效、细菌学疗效.结果 本研究入选病例4888例,其中367例南于不良事件致中途停药或给药方案错误等原因不能进行临床疗效评价,符合方案的临床疗效可评价病例为4521例,安全性评价4888例.左氧氟沙星500 mg静脉注射每日一次治疗细菌性感染的总有效率为90.8%(4103/4521);治疗呼吸系统感染、泌尿系统感染、消化系统感染、妇科感染、血液病合并感染的有效率分别为90.2%(2884/3198)、92.3%(810/878)、91.9%(203/221)、94.5%(120/127)、88.7%(86/97);细菌总清除率为80.3%(677/843).常见不良反应主要为胃肠道反应(3.9%,193/4888)、注射局部刺激(1.7%,84/4888),程度轻微,停药后消失.结论 左氧氟沙星500 mg静脉注射液每日一次可有效控制多系统细菌性感染,且不良反应少.     

氟罗沙星与氧氟沙星随机对照治疗细菌性感染228例临床研究

为评价氟罗沙星(FLX)的疗效和安全性,以氧氟沙星(OFX)为对照药,在228例细菌性感染病例中进行了随机对照观察,包括尿路感染115例、下呼吸道感染88例和腹腔感染25例。应用 FLX 者115例,OFX 者113例。治疗结果 FLX 和 OFX 组的总有效率分别为83.5%和84.1%,治愈率为67.0%和66.4%;细菌清除率各为85.0%和85.7%。两组的不良反应均轻微,呈一过性,发生率为11.3%(FLX 组)和10.5%(OFX 组),主要为消化道反应。两组差异无显著性。结论:在治疗常见细菌感染时,FLX200～400mg·日~(-1)·次~(-1)与 OFX200～300mg 每日2次,疗程5～14日的治疗方案,其疗效和安全性相仿。     

头孢泊肟酯治疗细菌性感染122例临床评价

用头孢泊肟酯治疗各系统细菌性感染１２２例，结果是：总有效率为９１．８％其中耳鼻喉科有效率为９７．５％下呼吸道感染有效率为９０．０％，泌尿系感染有效率为９０．０％外科及其它感染的有效率为８６．４％。总细菌清除率为９６．６％其中革兰阳性球菌的清除率为９６．９％革兰阴性杆菌的清除率为９６４低不良反应发生率为１８．９％。     

Double-blind comparison of cefixime and cefaclor in the treatment of acute otitis media in children

In a double-blind study cefixime, an oral cephalosporin of the third generation, was compared to cefaclor in the treatment of acute otitis media in 397 children aged 6 months to 12 years. Clinical evaluation was carried out at the beginning, at day 10-12 and day 28-35 after the start of the treatment. Specimens for bacterial culture and sensitivity testings were taken from the nasopharynx at the initial visit. Patients were randomized either to cefixime in a dose of 8 mg/kg/day or cefaclor in a dose 40 mg/kg/day in the proportion of 2 cefixime patients to 1 cefaclor patient. Two daily doses were administered for 7 days. At day 10-12, 93.5% in the cefixime group and 90.5% in the cefaclor group (p = 0.08) were clinically cured or improved. At day 28-35 the rate of cured or improved patients had decreased, mostly due to reinfections, to 90.1% in the cefixime group and to 86.6% in the cefaclor group (p = 0.12), respectively. 375 patients (69.9%) had positive bacterial culture in the nasopharynx of at least one strain of Haemophilus influenzae, Streptococcus pneumoniae, Branhamella (Moraxella) catarrhalis or combinations of these 3.73.6% of the B. catarrhalis strains were beta-lactamase producing and 11.4% of the H. influenzae strains, respectively. All isolated bacteria were sensitive to cefixime. Adverse events were reported in 17.9% in the cefixime and 10.6% in the cefaclor group. Most reactions were of moderate or mild nature and mostly affected skin or the gastrointestinal region. No serious adverse experiences occurred. In view of the good clinical results obtained cefixime seems to be at least as effective as cefaclor in the treatment of acute otitis media in children.     

Clinical evaluation of enoxacin]

436 patients with various infections were treated with 2 kinds of enoxacin preparations, tablets in 336 cases and capsules in 100 cases. The total effective rate for tablets and capsules was 97.0% and 95.0% respectively. The bacterial eradication rate was 96.8% for tablets and 96.7% for capsules. Adverse reactions were few and mild. A randomized study of enoxacin and norfloxacin in the treatment of 209 patients with enteric and urinary infections was carried out simultaneously, the effective rate of enoxacin (99.1%) was similar to norfloxacin (95.0%). The incidence of side effects in norfloxacin group was slightly higher than that in enoxacin (P less than 0.05).     

甲磺酸帕珠沙星注射液治疗急性细菌感染的疗效研究

目的评价帕珠沙星治疗急性细菌感染的临床疗效和安全性。方法采用随机、双盲、对照试验的方法,治疗组为甲磺酸帕珠沙星注射液,对照组为左氧氟沙星,每组各20例,纳入对象为呼吸道、泌尿道感染,甲磺酸帕珠沙星用量:轻度感染500 mg Qd静滴;中度感染500 mg B id静滴。左氧氟沙星用量:轻度感染200 mg Qd静滴;中度感染200 mg B id静滴。疗程均为7~14 d。结果甲磺酸帕珠沙星的临床治愈率70.0%(14/20),有效率90.0%(18/20),细菌清除率87.5%(14/16);对照组左氧氟沙星分别为65.0%(13/20),90.0%(18/20),86.7%(13/15)。帕珠沙星和左氧氟沙星不良反应发生率均为8.7%。以上结果经统计学处理,差异均无统计学意义(P均>0.05)。结论甲磺酸帕珠沙星是治疗轻中度呼吸道、泌尿道感染有效、安全的抗菌药物。     

A clinical model for diagnosis of urinary tract infection in young women

To develop a clinical model for diagnosis of bacterial urinary tract infection, we conducted a prospective study on 266 dysuric young women, 147 of whom had urinary tract infections. Five variables were found to be significant and independent correlates to bacterial urinary tract infection on logistic regression analysis: sexual activity, absence of vaginal discharge, short duration of complaints, leukocyturia, and hematuria. An algorithm combining the logistic model and a Gram-stained urine specimen, which was used in only a third of our patients, afforded a sensitivity of 86% and a specificity of 84%. The algorithm was validated in a second set of 166 dysuric women, 77 of whom had urinary tract infections. The algorithm led to a diagnosis of bacterial urinary tract infection with a sensitivity of 91% and specificity of 79%; the only laboratory test needed except for urinalysis was a Gram's stain of urine, obtained for 30% of the patients.     

Blinded comparison of cefuroxime to cefaclor for lower respiratory tract infections

Cefuroxime axetil was compared with cefaclor for the therapy for lower respiratory tract infections. Sixty-one patients were randomized to receive the following drug dosages: (1) cefuroxime axetil, 250 mg orally every 12 hours (21 patients); (2) cefuroxime axetil, 500 mg orally every 12 hours (21 patients); and (3) cefaclor, 500 mg orally every eight hours (19 patients). Of these 61 patients, 80% were male, with a mean age of 59.5 years; 56% had acute pneumonia, and the remainder had an acute bronchitis. Causative pathogens included typical respiratory tract pathogens. Overall, 23 of 27 patients with bronchitis were clinically cured at the end of therapy. Thirty-one of 34 pneumonias were clinically cured or improved at the end of therapy; the three pneumonia treatment failures occurred in the lower dose cefuroxime (n = 2) and cefaclor (n = 1) treatment groups. Overall, bacteriologic cure occurred in 86% of patients treated with 500 mg of cefuroxime axetil compared with 60% of cefaclor-treated patients. Adverse clinical effects were uncommon. From this study, it was concluded that cefuroxime given every 12 hours is at least as clinically efficacious as cefaclor; it is a new oral cephalosporin with pharmacologic and bacterial spectrum advantages over many older agents.     

Norfloxacin: a new targeted fluoroquinolone antimicrobial agent

Norfloxacin is an oral fluoroquinolone antimicrobial agent recently released for the treatment of uncomplicated and complicated urinary tract infections. The drug antagonizes DNA gyrase, an enzyme essential for bacterial DNA replication. Norfloxacin is more potent and broader in spectrum than the earlier developed analogue, nalidixic acid, and is active in vitro against virtually all bacterial pathogens causing urinary tract and gastrointestinal infections, aerobic gram-negative bacilli causing sepsis in neutropenic patients, and Neisseria gonorrhoeae. The drug is administered orally twice daily and achieves high concentrations in urine, stool, renal tissue, and bile. Norfloxacin was at least as effective as currently used agents in treating urinary tract infections, and, in limited studies, bacterial gastroenteritis, gonorrhea, bacterial prostatitis, and prevention of gram-negative bacillary infection in neutropenic patients. Adverse drug effects were mild and included disturbances of the gastrointestinal tract and the central nervous system. Norfloxacin shows promise as an antibacterial agent for genitourinary and gastrointestinal infections.