加替沙星序贯治疗老年下呼吸道感染临床观察

Sequential Therapy of Gatifloxacin in Elder Inpatients with Lower Respiratory Tract Infection: A Clinical Observation

目的评价国产加替沙星序贯治疗老年下呼吸道感染的临床疗效和安全性.方法将95例老年患者随机分为两组,治疗组予加替沙星序贯治疗,对照组予左氧氟沙星静脉滴注,剂量400mg/d,疗程7～14 d.结果治疗组46例,临床疗效评价43例,安全性评价46例;对照组49例,临床疗效评价41例,安全性评价48例;两组临床总痊愈率和有效率分别为79.07%和95.35%与82.93%和95.12%,细菌清除率分别为94.59%和89.47%,加替沙星和左氧氟沙星对临床分离菌药敏试验敏感率,分别为97.56%和92.68%;其结果经比较差异均无显著性（P＞0.05）;药物不良反应发生率分别为23.91%和43.75%（P＜0.05）,共出现严重不良反应5例.结论加替沙星序贯治疗老年下呼吸道感染可获良好疗效,但也要关注其不良反应,严格掌握适应证,注意合理用药.

OBJECTIVE To evaluate the clinical efficacy and safety of domestic gatifloxacin in the treatment of lower respiratory tract infections of elder people. METHODS Ninety five patients were randomly divided into two groups. Both gatifloxacin and levofloxacin were separately administered at a dose of 400mg,once a day for 7 to 14 days. But gatifloxacin group was selected intravenous-oral sequential therapy while levofloxacin group was adopted continuous intravenous infusion. RESULTS Forty six patients were enrolled in gatifloxacin group, 46 patients were assessed for safety and 43 patients for efficacy, while 49 patients were enrolled in levofloxacin group, 48 patients were assessed for safety and 41 patients for efficacy. The overall cure rates and efficacy rates were 79.07%, and 95.35%in gatifloxacin group, and 82. 93%, and 95.12% in levofloxacin group, respectively. The bacterial clearance rates were 94.59%（in gatifloxacin group） and 89.47% （in levofloxacin group）, there was no significant difference （P〉0. 05） between two groups in the above results. Disc agar diffusion test showed the sensitivity rates of overall clinical isolates to gatifloxacin and levofloxacin were 97.56% and 92.68%, respectively. The incidence of adverse drug reactions （ADR） of two groups were 23.91% and 43. 75%, respectively. In 5 cases severe ADR were found. CONCLUSIONS Sequential therapy of gatifloxacin may get satisfactory results in lower respiratory tract infections of elder people. The irrational use of drugs is an important factor to increase ADR （including collateral damage）. So we should pay attention to the ADR and grasp the indications strictly and use the drugs appropriately, especially for the elder patients.