莫西沙星序贯治疗老年社区获得性肺炎临床研究  

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

作　　者：黄刚[1] 蒋一雅[1] 周燕娟[1] 凌夏君[1] 仇铁锋 周尧 瞿介明[2] 

机构地区：[1]江苏大学附属武进医院呼吸科,江苏常州213002 [2]复旦大学附属华东医院呼吸科,上海200040

出　　处：《南京医科大学学报（自然科学版）》2008年第11期1457-1460,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏大学2005年临床医学科技发展基金资助(JLY20050041)

摘　　要：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。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 nd, 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,onee daily until to sequential switch time window,followed by oral administration of Cefuroxime tablet 250 mg,twice daily and Azithromycin table 500 mg,onee 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 differenee（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.

关 键 词：莫西沙星 老年 社区获得性肺炎 序贯治疗 

分 类 号：R563.1[医药卫生—呼吸系统]