首选口服大环内酯类抗菌药物门诊治疗下呼吸道感染疗效评价  

Efficacy of Preferred Oral Macrolides Antibiotics in Outpatients with Lower Respiratory Tract Infections

作　　者：窦维嘉 宋志芳[2] 

机构地区：[1]温州医学院研究生部,浙江省温州市325035 [2]上海交通大学医学院附属新华医院崇明分院急危重症医学科

出　　处：《中国全科医学》2014年第1期105-109,共5页Chinese General Practice

基　　金：上海交通大学科技基金项目(10XJ22017)

摘　　要：目的评价门诊首选口服大环内酯类药物治疗下呼吸道感染(LRTIs)的临床疗效。方法以呼吸科专家门诊LRTIs〔包括社区获得性肺炎(CAP)〕患者为研究对象,对低危人群前瞻性首选大环内酯类药物(红霉素、国产或进口克拉霉素,即分别为方案一、二、三)口服抗感染治疗,对高危人群前瞻性首选大环内酯类药物(红霉素或克拉霉素)联合二代头孢(方案四)或单用莫西沙星(方案五),随访7 d、14 d、21 d评价疗效。结果 197例患者中,男/女82例(41.6%)/115例(58.4%),平均年龄为(52±17)岁。几种治疗方案7 d总有效率(好转+治愈)为96.0%(189/197),临床治愈率为58.4%(115/197);方案一(红霉素)治疗组122例(61.9%),7 d临床治愈率为74.6%(91/122),其中急性支气管炎临床治愈率达78.9%(75/95);莫西沙星用于高危患者,7 d好转率为73.7%(14/19),治愈率为21.0%(4/19)。结论首选大环内酯类药物(红霉素、克拉霉素)或莫西沙星口服门诊治疗LRTIs(包括CAP)疗效确切可靠。Objective To evaluate the clinical efficacy of preferred oral macrolides antibiotics among outpatient with lower respiratory tract infections （LRTIs） . Methods A total of 197 outpatients with LRTIs （including community acquired pneumonia （CAP） J treated in respiratory specialist clinics were included in this study. The low - risk patients were treated with oral macrolides antibiotics （erythromycin in the first treatment group, homemade clarithromycin in the second treatment group, and imported claricid in the third treatment group）; while the high - risk patients were treated with macrolides antibiotics combined with second generation of cephalosporins （ the fourth treatment group） or treaded only with moxifloxacin （the fifth treatment group） . The clinical efficacy in the five groups was evaluated after 7 days, 14 days, and 21 days, respectively. Results There were 82 male patients （41. 6%） and 115 female patients （58.4%） with an average age of （52 ± 17） years. The total effective rate including improvement rate and cure rate after 7 days was 96.0% （189/197）, of which the cure rate was 58.4% （1151 197）. Among the 122 patients in the first treatment group, the cure rate after 7 days was 74. 6% （91/122）, and the cure rate of acute bronchitis was 78. 9% （75195） . Meanwhile, among the 19 high - risk patients in the fifth treatment group, the improvement rate and cure rate after 7 days were 73. 7% （14/19） and 21. 0% （4/19） respectively. Conclusion The preferred oral macrolides antibiotics and moxifloxacin are effective in treating LRTIs （including CAP） in outpatients.

关 键 词：大环内酯类 投药 口服 下呼吸道感染 治疗结果 

分 类 号：R978.15[医药卫生—药品]