莫西沙星治疗106例社区获得性肺炎病人的前瞻性研究

Prospective study of moxifloxacin in 106 patients with community-acquired pneumonia

目的:评价莫西沙星在社区获得性肺炎(CAP)中的临床应用价值。方法:采用前瞻性设计,220例CAP病人随机分为试验组106例,其中轻度40例,中度66例,均用莫西沙星片0.4～0.8g,po,qd,疗程10d。对照组114例,其中44例轻度病人用克拉霉素片0.5g,po,bid,疗程14d或头孢呋新1.5g,iv,bid,疗程10d,70例中度病人用头孢呋新1.5g,iv,bid,疗程10d或头孢哌酮3.0g,iv,bid疗程10d或氨苄西林舒巴坦3.0g,iv,bid疗程10d。结果:轻度病人试验组和对照组治愈率均为95%,中度病人试验组和对照组治愈率为85%和86%,差异无显著意义(P>0.05)。但试验组多种症状(发热、咳嗽、痰液性状改善、胸痛等)缓解时间、d3和d5治愈率与对照组比较差异有显著意义(P<0.01,P<0.05),不良反应少,均可耐受。本次试验CAP病原体检出率低(29.4%)。结论:莫西沙星治疗CAP临床疗效肯定,安全,给药方便。

AIM: To study the clinical application of moxifloxacin in treatment of community-acquired pneumonia(CAP). METHODS: A Prospective design was conducted, 220 adult patients with CAP were radomly divided into two study groups treated with moxifloxacin and two control groups treated with others antibiotics according to the severity of illness. The 106 patients in study groups were treated with moxifloxacin 0.4-0.8 g, po, qd for 10 d. In control groups, 44 patients with mild CAP were treated with clalithromycin 0.5 g, po, bid for 14 d or ceforuxime injection 2.5 g, iv, gtt, bid for 10 d; 70 patients with moderate CAP were treated with ceforuxime injection 2.5 g, iv, gtt, bid for 10 d, cefaropatone injection 3.0 g, iv,gtt, bid for 10 d or ampicillin/sobatan injection 3.0 g, iv,gtt, bid for 10 d. Statistical difference was analyzed in terms of effectiveness, side effects and compliance among the groups. RESULTS: The total cured rate of two study groups were 95 % and 85 %, respectively; while those of two control groups were 95 % and 86 %, respectively; resulting in no significant difference (P>0.05)(95 % vs 95 %, 85 % vs 86 %), but the difference in cured rates on d 3 and d 5 were significant (P<0.01, P<0.05) among the groups. The clinical sign and symptom such as fever, cough and chest pain in treated groups were alleviated earlier than in the control groups(P<0.01, P<0.05). A few side effects caused by moxifloxacin were recorded during the period of treatment. Specific pathogens of CAP could only be found in 28.6 % of the patients. CONCLUSION: Moxifloxacin is effective, safe and convenient for cusing mild or modesate CAP, and therefore ought to the secommended.