米卡芬净治疗光滑念珠菌和克柔念珠菌致念珠菌血症或侵袭性念珠菌病的转归

念珠菌属是医院获得性血流感染的常见病原菌之一,目前光滑念珠菌和克柔念珠菌约占念珠菌血症或侵袭性念珠菌病病原菌的25%。多项临床试验证实米卡芬净治疗念珠菌血症有效,但单个试验有一定局限性.光滑念珠菌和克柔念珠菌例数较少,本研究对2例评估米卡芬净治疗念珠菌血症及侵袭性念珠菌病的随机对照试验进行分析,评价米卡芬     

卡泊芬净治疗肾移植后肺部侵袭性真菌感染：12例分析

背景：肾移植后侵袭性真菌感染是肾移植失败的主要原因。卡泊芬净具有独特的抗真菌机制,对氟康唑和伊曲康唑耐药的念珠菌有很强的抗菌作用,并表现出很好的耐受性,且没有与剂量或作用持续时间相关的毒性。 目的：评价卡泊芬净治疗肾移植后肺部侵袭性真菌感染的有效性和安全性。 方法：回顾性分析2013年1至12月三门峡市中心医院呼吸科诊断为肺部侵袭性真菌感染的肾移植患者,采用卡泊芬净抗真菌治疗,卡泊芬净首剂为70 mg/d,继以50 mg/d,静脉滴注。用药后每周最少监测2次肝功能,若肝功能损害加重或出现新的肝功能损害,根据肝脏功能调整剂量或者停药,疗程为10-14 d。观察患者的疗效和不良反应。 结果与结论：共收治12例患者,可以找到真菌微生物学证据者占67%,其培养真菌以念珠菌为主,占75%,合并细菌感染比例为58%,合并巨细胞病毒感染的比例为25%。治疗有效率为92%（11/12）,死亡率为8%（1/12）,不良事件发生率为25%。提示对于肾移植后侵袭性真菌感染患者的经验性抗真菌治疗,卡泊芬净的疗效较好,且不良事件发生率低。卡泊芬净可以作为肾移植后侵袭性真菌感染的首选药物。     

卡泊芬净治疗侵袭性真菌病的临床研究

目的 探讨卡泊芬净治疗侵袭性真菌病(IFD)的疗效与安全性.方法 回顾分析北京安贞医院呼吸科、急诊科和外科ICU接受卡泊芬净治疗的IFD患者临床资料.结果 2005年5月-2009年12月共35例接受卡泊芬净治疗患者.其中,确诊20例,包括念珠菌血症18例(白念珠菌10例,近平滑念珠菌3例,光滑念珠菌和热带念珠菌各2...     

卡泊芬净治疗重症监护病房侵袭性真菌感染13例临床分析

目的探讨卡泊芬净治疗ICU侵袭性真菌感染(IFI)的疗效与安全性。方法回顾分析我院呼吸、急诊和外科ICU接受过卡泊芬净治疗的IFI患者临床资料。结果2005年5月—2006年11月共有13例接受了卡泊芬净治疗。13例中确诊IFI6例,包括念珠菌菌血症4例(白念珠菌2例,光滑念珠菌和近平滑念珠各1例)、肺IFI2例(光滑念珠菌和曲霉各1例);拟诊肺IFI3例(白念珠菌1例,曲霉2例);疑似肺IFI4例,病原真菌不明。基础疾病为心血管外科术后8例,骨科与普外科术后各1例,肺癌术后复发化疗、间质性肺疾病和成人Still′s病各1例。卡泊芬净中位疗程14(1~55d)d。1例于用药当天死于心脏骤停疗效无法判断,12例可评估患者中,痊愈4例(4/12,33.3%),显效4例(4/12,33.3%),总有效率(8/12,66.7%),进步和无效各2例。死亡6例(6/13,病死率46.2%)。治疗过程中未发现与卡泊芬净有关的不良反应。结论卡泊芬净是治疗IFI有效、安全的药物,值得进一步临床验证。     

腹腔念珠菌病诊疗进展

<正>侵袭性念珠菌病(IC)是一种与医疗技术进步相关的真菌感染性疾病，根据念珠菌侵袭部位的不同，可分为念珠菌血症和深部念珠菌病(包括腹腔、肝脾、脑、眼、心脏、关节)^[1-2]。腹腔念珠菌病(IAC)是一类特殊的腹腔真菌感染疾病，腹腔真菌感染占腹腔感染的10%～15%，致病真菌中70%～90%为念珠菌，在重症监护病房(ICU)中由念珠菌导致的腹腔感染比例更高，     

卡泊芬净经验性治疗粒细胞减少伴持续发热患者的安全性、耐受性和疗效的非对照、开放、多中心临床研究

目的评价卡泊芬净注射剂经验性治疗粒细胞减少伴持续发热患者的安全性、耐受性和疗效。方法本研究为非对照、开放、多中心临床试验，患者因化疗或接受造血干细胞移植出现中性粒细胞绝对值计数〈500×10^6／L，持续至少96h，入选前接受胃肠外广谱抗菌药治疗至少96h，并且在入选前24h内体温〉38．0℃者可入选本研究。统计用药人群发生的严重不良事件、不良事件及其总有效率。结果共入选131例，其中安全性分析集（SS）131例，全分析集（FAS）129例。SS131例中，18例受试者发生24例次临床严重不良事件，均与研究药物无关，发生1例次实验室严重不良事件（血钾降低），与研究药物肯定有关。SS131例中发生与药物有关的非严重不良事件者35例，包括5例同时发生临床不良反应和实验室异常；其中16例发生临床不良反应，多见皮疹、发热、呕吐等；24例发生实验室异常，多见ALT等肝酶升高、血钾降低等。总不良反应发生率为26．7％（35／131），其中临床不良反应发生率为12．2％（16／131），实验室异常发生率为19．1%（25／131）。临床不良反应中91．3%为轻、中度。入选病例中9例（12例次）因不良反应而中止治疗，占6．9％（9／131）。其中6例（9例次）被评价为与试验药物有关，发生率为4．6％（6／131）。FAS和符合方案数据集（PPS）中的总体有效率分别为36．4％（47／129）和40．2％（47／117）。结论卡泊芬净经验性治疗粒细胞减少伴持续发热患者临床不良反应多为轻、中度，患者对其耐受性良好，因药物不良反应中止治疗者少见。卡泊芬净用于经验性治疗粒细胞减少伴发热可获一定疗效。     

危重病科念珠菌血症23例临床分析

目的探讨ICU危重症患者念珠菌血症的临床特点及其防治策略。方法回顾性分析我院ICU念珠菌血症患者的临床资料。结果23例院内获得性感染患者中血培养共获得念珠菌菌株23株,其中白色假丝酵母菌12株（52.2%）,非白色假丝酵母菌11株（47.8%）。使用广谱抗生素18例,中心静脉置管16例,高龄15例,腹部手术10例,ICU住院＞7天19例,气管插管13例,急性生理慢性健康评分（APACHEⅡ）≥20分14例。血清降钙素原（PCT）含量为（0.58±0.25） μg/L,(1,3) β D 葡聚糖（G实验）为（210.1±147.9） ng/L。15例患者给予卡泊芬净。总病死率47.8%。结论念珠菌血症仍以白色念珠菌感染为主,多发生于具有多种易感因素者。对高危患者应重视PCT和G实验检测及病原学检查,及时合理选用抗真菌药物。     

棘白菌素对念珠菌体外药敏试验产生“矛盾现象”的分析

目的观察棘白菌素对念珠菌的"矛盾现象"。方法体外药敏试验中,采用微量稀释法分别观察卡泊芬净和米卡芬净对180株念珠菌的最低抑菌浓度(MIC)和"矛盾现象"。结果卡泊芬净对白色念珠菌、热带念珠菌、近平滑念珠菌和光滑念珠菌均产生"矛盾现象",发生率分别为66.0%、77.5%、55.0%和35.0%,各菌矛盾现象的起点/终点中位数浓度分别为8/32、16/32、8/32、4/16μg/mL;米卡芬净只对白色念珠菌和热带念珠菌产生"矛盾现象",发生率分别为45%和67.5%,各菌矛盾现象的起点/终点中位数浓度分别为4/16、8/32μg/mL。结论 "矛盾现象"的产生存在念珠菌种间差异性和棘白菌素类药物特异性。卡泊芬净出现"矛盾现象"的发生率高于米卡芬净。各菌株对卡泊芬净、米卡芬净产生"矛盾现象"的发生率与MIC的高低无明显相关性。     

回顾卡芬净治疗高龄肺部真菌感染的疗效分析

目的：探讨卡泊芬净治疗高龄侵袭性肺部真菌感染患者的疗效和安全性。方法入选北京友谊医院医疗保健中心2010年12月至2012年7月接受过卡泊芬净治疗的侵袭性肺部真菌感染患者32例,对临床资料进行分析。根据诊断分为临床诊断病例（n=19）、拟诊病例（n=13）。根据侵袭性真菌感染的疗效评价标准,判定卡泊芬净对高龄侵袭性肺部真菌感染患者的有效率。同时观察该药的安全性。结果共入选32例80岁以上高龄患者。治疗的总有效率为71.9%。其中,痊愈15例（46.9%）,显效8例（25%）,进步5例（15.6%）,无效4例（12.5%）。治疗过程中2例患者出现谷丙转氨酶升高,考虑为与用药有关的肝功能受损所致。结论卡泊芬净对于治疗高龄患者侵袭性真菌感染安全有效。     

念珠菌病的预防

推荐:急性白血病诱导化疗期间的预防1.建议选用氟康唑每日400mg(6mg/L)静脉滴注或口服,或卡泊芬净每日50mg/L,或伊曲康唑口服液每日2.5mg/kg,每日2次(1mL内含10mg)。2.建议选用泊沙康唑混悬液每日200mg,每日3次(1mL内含40mg)口服(国内尚未上市,国     

Caspofungin susceptibility testing of isolates from patients with esophageal candidiasis or invasive candidiasis: relationship of MIC to treatment outcome

The caspofungin clinical trial database offers an opportunity to assess susceptibility results for Candida pathogens obtained from patients with candidiasis and allows for correlations between efficacy outcomes and MICs. Candida isolates have been identified from patients enrolled in four studies of esophageal candidiasis and two studies of invasive candidiasis. The MICs of caspofungin for all baseline isolates were measured at a central laboratory using NCCLS criteria (document M-27A); MICs for caspofungin were defined as the lowest concentration inhibiting prominent growth at 24 h. MICs were then compared to clinical and microbiological outcomes across the two diseases. Susceptibility testing for caspofungin was performed on 515 unique baseline isolates of Candida spp. obtained from patients with esophageal candidiasis. MICs for caspofungin ranged from 0.008 to 4 microg/ml; the MIC50 and MIC90 were 0.5 and 1.0 microg/ml, respectively. Susceptibility testing was also performed on 231 unique baseline isolates of Candida spp. from patients with invasive candidiasis. The majority (approximately 96%) of MICs were between 0.125 and 2 microg/ml, with MIC50 and MIC90 for caspofungin being 0.5 and 2.0 microg/ml, respectively. Overall, caspofungin demonstrated potent in vitro activity against clinical isolates of Candida species. A relationship between MIC for caspofungin and treatment outcome was not seen for patients with either esophageal candidiasis or invasive candidiasis. Patients with isolates for which the MICs were highest (>2 microg/ml) had better outcomes than patients with isolates for which the MICs were lower (<1 microg/ml). Additionally, no correlation between MIC and outcome was identified for specific Candida species.     

Caspofungin for the treatment of less common forms of invasive candidiasis

OBJECTIVES: Caspofungin has demonstrated efficacy in invasive candidiasis. However, in a comparative study, most patients (>83%) had candidaemia. Therefore, we performed a study in patients with non-fungaemic invasive candidiasis. PATIENTS AND METHODS: Adults with proven non-fungaemic invasive candidiasis or probable chronic disseminated candidiasis (CDC) received caspofungin primary or salvage monotherapy. Most patients received 50 mg daily following a 70 mg loading dose. Patients with endocarditis, osteomyelitis or septic arthritis received caspofungin at 100 mg daily and were allowed dose escalation up to 150 mg. Primary efficacy endpoint was the overall response at end of caspofungin therapy. A favourable overall response required complete resolution of symptoms and either eradication of Candida or radiographic resolution. RESULTS: All 48 patients enrolled had confirmed infection and received>or=1 dose of caspofungin. At study entry, 8% were neutropenic. The mean APACHE II score was 14.3. Most infections were due to Candida albicans (60%) or Candida glabrata (14%). The overall success at end of caspofungin therapy was 81%. Success by site of infection was as follows: peritonitis 77% (10/13), abdominal abscess 89% (8/9), CDC 88% (7/8), osteomyelitis/septic arthritis 100% (4/4), endocarditis 33% (1/3) and multiple sites 75% (6/8). Outcomes were similar across Candida spp. None of the patients had a serious drug-related adverse event or discontinued caspofungin due to toxicity. Overall mortality until 12 week follow-up was 23%. CONCLUSIONS: In deep-seated invasive candidiasis, including peritonitis, abdominal abscesses, CDC and arthritis, caspofungin was effective and safe at regular doses and up to 100 mg daily.     

Second-line therapy with caspofungin for mucosal or invasive candidiasis: results from the caspofungin compassionate-use study

OBJECTIVES: To prospectively assess the efficacy and safety of caspofungin as second-line therapy for mucosal or invasive candidiasis in patients enrolled in the caspofungin compassionate-use study. MATERIALS AND METHODS: Thirty-seven patients with mucosal or invasive candida infections (17 oesophageal, four oropharyngeal and 16 invasive candidiasis) were enrolled in the caspofungin compassionate-use study. All patients were refractory to or intolerant of intravenous amphotericin B or lipid amphotericin formulation(s). Efficacy was assessed at the end of intravenous caspofungin therapy based on clinical (and, where appropriate, microbiological) response. RESULTS: HIV was the most common (91%) risk factor in patients with mucosal candidiasis; patients with invasive candidiasis commonly had acute leukaemia/lymphoma (50%) or diabetes mellitus (31%). Most patients with mucosal candidiasis (91%) and invasive candidiasis (94%) were refractory to >/=1 antifungal agent(s). A favourable response was noted in 82% (14/17) with oesophageal candidiasis, 100% (4/4) with oropharyngeal candidiasis and 87% (13/15) with invasive candidiasis. Caspofungin was generally well tolerated; one serious drug-related adverse event was reported. CONCLUSION: In this study, caspofungin was an effective alternative for patients with refractory candida infections.     

Invasive candidiasis treated in the intensive care unit: observations from a randomized clinical trial

OBJECTIVES: The objectives of this study were to contrast risk factors, microbiology, and outcomes in patients with invasive candidiasis treated in an intensive care unit (ICU) with those in patients with invasive candidiasis treated outside an ICU and to describe therapeutic results with caspofungin in ICU patients. MATERIALS AND METHODS: We retrospectively identified patients with documented invasive candidiasis who received their first dose of the study drug in the ICU as part of a double-blind randomized trial. Participants were not stratified at entry by their ICU status. Patients received caspofungin (50 mg/d after a 70-mg loading dose) or conventional amphotericin B (0.6-1.0 mg/kg per day) for 10 to 14 days. A favorable response required resolution of signs and symptoms as well as eradication of Candida pathogens. RESULTS: Of the 224 patients, 97 (43%) received their first dose of the study drug in the ICU. Most patients had well-recognized risk factors for invasive candidiasis, including broad-spectrum antibiotics, central venous catheters, and hyperalimentation. Recent surgery was more common whereas malignancy, neutropenia, and immunosuppression were less common among ICU patients than among non-ICU patients. Candidemia was demonstrated in 81% of ICU patients and in 84% of non-ICU patients. Favorable response rates in the ICU patients vs the non-ICU patients were 68% (95% confidence interval [CI] = 53%, 82%) vs 77% (95% CI = 67%, 87%) for caspofungin and 56% (95% CI = 43%, 69%) vs 67% (95% CI = 55%, 79%) for amphotericin B. After accounting for differences in APACHE (Acute Physiology and Chronic Health Evaluation) II score, neutropenia status, and geographic region, we found that patients initiating the study therapy in an ICU were still more likely to die than patients initiating study therapy outside an ICU. For ICU patients, all-cause mortality rates were 45% (95% CI = 30%, 60%) for caspofungin recipients and 40% (95% CI = 28%, 53%) for amphotericin B recipients, whereas candidiasis-attributable mortality rates were 5% (95% CI = 0%, 12%) for caspofungin recipients and 11% (95% CI = 3%, 19%) for amphotericin B recipients. Overall, drug-related adverse events were reported less often among the ICU patients than among the non-ICU patients. CONCLUSIONS: In ICU patients treated with antifungal therapy, invasive candidiasis is associated with substantial mortality, but most deaths cannot be directly attributed to this infection.     

Clinical efficacy and safety of intravenous itraconazole in the management of invasive candidiasis in patients of surgery and critical care

Although itraconazole exhibits potent activity against Candida species, there have been few studies examining the use of intravenous itraconazole in the treatment of invasive candidiasis. A nationwide multicenter clinical study was conducted to evaluate the efficacy and safety of intravenous itraconazole in the management of invasive candidiasis, including non-albicans Candida species, in non-neutropenic patients undergoing surgery and critical care. Between September 2007 and August 2009, patients with proven and presumed candidiasis were enrolled at 22 participating institutions. Patients with presumed candidiasis had a deep-body temperature of 37.8°C or higher and were positive for serum β-D: -glucan or two or more colonization sites of Candida species. The main exclusion criterion was severe renal impairment (creatinine clearance <30 ml/min). The primary efficacy analysis was based on clinical and microbiological responses 5-10 days after the end of treatment, assessed by an independent data review committee. Of the 60 patients enrolled, 49 were included in the modified intention-to-treat population; 31 patients received a definitive diagnosis and 18 patients a presumed diagnosis. Intravenous itraconazole was used as first-line therapy to treat 39 patients and as second-line therapy for 10 patients. The isolated species included Candida albicans (25 strains with definitive diagnosis and 17 with presumed diagnosis) and non-albicans species (16 and 10, respectively). Treatment was successful in 61.5% patients (65.5% in first-line and 50.0% in second-line therapy); 60% of proven invasive candidiasis (IC) patients were judged as successful compared with 63.2% of presumed candidiasis patients. Eradication rate was 63.6% for C. albicans and 71.4% for C. glabrata. Adverse effects occurred in 9 of 60 patients (15.0%), commonly impaired liver function. The clinical efficacy and safety of intravenous itraconazole were suggested in the management of proven and presumed candidiasis including C. glabrata in non-neutropenic patients. The status of intravenous itraconazole in the Japanese guideline warrants reconsideration.     

细菌性阴道病及假丝酵母菌病的感染情况及相关因素分析

目的了解本地区女性细菌性阴道病（BV）及外阴阴道假丝酵母菌病（VVC）的发病情况及影响疾病的相关因素。方法回顾性分析2011-2013年本院1967例女性体检情况,并进行统计分析,采用问卷调查方式分析影响BV、VVC发病的相关因素。结果1967例体检检出282例女性VVC,检出率14．34％（282／1967）;检出231例BV,检出率11．74％（231／1967）;VVC以25～35岁性活跃期年龄段检出率较高,BV发病率各年龄层差异无统计学意义（P〉0．05）;VVC及BV治疗效果及疗效影响因素经Logistic分析,流产为影响治疗效果的危险因素;男方配合治疗及使用避孕套为康复效果的保护性因素。结论VVC与BV均与阴道微生态失衡相关,治疗中应注意指导患者养成健康的卫生习惯,注重男方协同治疗,阻断交叉感染,以保证良好的治疗效果。     

Randomized, double-blind, multicenter study of caspofungin versus amphotericin B for treatment of oropharyngeal and esophageal candidiases.

Caspofungin is an antifungal agent of the novel echinocandin class. We investigated its efficacy, safety, and tolerability as therapy for oropharyngeal and/or esophageal candidiasis in a phase II dose-ranging study. Patients were randomized in a double-blind manner to receive either caspofungin acetate (35, 50, or 70 mg) or amphotericin B (0.5 mg/kg of body weight) intravenously once daily for 7 to 14 days. A favorable response required both complete resolution of symptoms and quantifiable improvement of mucosal lesions 3 to 4 days after discontinuation of study drug. Efficacy was assessed using a modified intent-to-treat analysis. No hypothesis testing of efficacy was planned or performed. Of 140 enrolled patients, 63% had esophageal involvement and 98% were infected with the human immunodeficiency virus (HIV) (median CD4 count, 30/mm(3)). A modestly higher proportion of patients in each of the caspofungin groups (74 to 91%) achieved favorable responses compared to amphotericin B recipients (63%), but there was considerable overlap in the 95% confidence intervals surrounding these point estimates. Similar trends were found in the subgroups with esophageal involvement, a history of fluconazole failure, and CD4 counts of < or =50/mm(3). A smaller proportion of patients receiving any dose of caspofungin experienced drug-related adverse events compared to patients given standard doses of conventional amphotericin B (P < 0.01). Caspofungin provided a generally well-tolerated parenteral therapeutic option for HIV-infected patients with oropharyngeal and/or esophageal candidiasis in this study.     

Treatment with caspofungin in immunocompromised paediatric patients: a multicentre survey

OBJECTIVES: Although a paediatric dosage has not been established, caspofungin is occasionally used in paediatric patients. We conducted a multicentre retrospective survey to obtain data on immunocompromised paediatric patients considered to require caspofungin therapy. METHODS: The survey identified 64 patients (median age: 11.5 years; 25 females, 39 males) with haematological malignancies (48), marrow failure (9), solid tumours (3), haematological disorders (2) and congenital immunodeficiency (2) who received caspofungin for proven (17), probable (14) and possible (17) invasive fungal infections or empirically (16). Caspofungin was administered until intolerance or maximum efficacy at dosages individually determined by the responsible physician for refractory infection (38), intolerance of other agents (10) or as best therapeutic option (16). RESULTS: The 64 patients received caspofungin for a median of 37 days (range 3-218) as single agent (20) or in combination (44). The median daily maintenance dosage was 1.07 mg/kg (95% CI 1.09-1.35; range 0.40-2.92) or 34.3 mg/m2 (95% CI 32.3-37.3; range 16.3-57.5). In none of the patients was therapy discontinued due to adverse events (AEs). Clinical AEs were mild to moderate and observed in 34 patients (53.1%). While mean glutamate pyruvate transaminase and glutamate oxalate transaminase values were slightly (P < 0.005) higher at the end of treatment (EOT), serum bilirubin, alkaline phosphatase and creatinine values were not different from baseline. Complete responses, partial responses or stabilization were observed in 5/7/3 of 17 patients with proven, in 3/4/3 of 14 patients with probable and in 7/6/1 of 15 evaluable patients with possible invasive infections. Thirteen of 16 patients on empirical therapy completed without breakthrough infection. Overall survival was 75% at the EOT and 70% at 3 months post-EOT, respectively. CONCLUSIONS: Caspofungin displayed favourable safety and tolerance and may have useful antifungal efficacy in severely immunocompromised paediatric patients.     

左氧氟沙星750mg注射液5日短程疗法治疗社区获得性肺炎的多中心临床研究

目的：比较左氧氟沙星750 mg注射液5 d短程疗法与500 mg注射液7-14 d常规疗法治疗社区获得性肺炎（CAP）疗效和安全性差异。方法本临床试验为随机对照、开放、非劣效性多中心临床试验。CAP患者被随机分配到左氧氟沙星750 mg组治疗5 d或500 mg组治疗7-14 d ,两组均接受静脉给药治疗,观察其临床表现、实验室检查、影像学改变及微生物学检查等,比较两组安全性和疗效差异。结果10个研究中心共入选病例241例。其中全分析集（FAS ）223例,包括750 mg组111例,500 mg组112例。符合方案分析集（PPS）211例,包括750 mg组107例,500 mg组104例。安全性分析集（SS）241例,包括750 mg组121例,500 mg组120例。FAS 750 mg组疗程中位数为5．0 d ,500 mg组疗程中位数为9．0 d。750 mg组总剂量中位数为3750 mg ,500 mg组总剂量中位数为4500 mg。FAS第4次随访750 mg组有效率为86．2％,500 mg组有效率为84．7％,两组综合疗效评价相比为非劣效。FAS 750 mg组可进行微生物疗效评价者共40例,获病原菌41株,500 mg组可行微生物疗效评价者共49例,获病原菌51株,两组细菌清除率均为100％。另外,750 mg组和500 mg组的非典型病原体的临床有效率均为100％。对750 mg组安全性观察结果显示,临床不良反应最常见为注射部位瘙痒、疼痛和充血等,其次为失眠、恶心、皮疹等。较常见的实验室指标异常为中性粒细胞比率降低、白细胞总数降低、ALT升高、AST升高等。以上不良反应多属轻微,患者可耐受,与500 mg组相比,因药物中止试验和不良反应发生率差异无统计学意义,提示两组安全性相仿。结论左氧氟沙星750 mg注射液5 d短程疗法治疗CAP与左氧氟沙星500 mg注射液7-14 d常规疗程相比,其临床和微生物疗效相仿,不良反应发生率相仿,均较轻微,患者耐受性好。