头孢西丁与头孢美唑随机对照治疗细菌性感染124例临床评价

A RANDOMIZED CONTROLLED CLINICAL EVALUATION ON CEFOXITIN COMPARED WITH CEFMETAZOLE IN TREATMENT OF 124 PATIENTS WITH BACTERIAL INFECTIONS

本研究采用随机对照临床设计评价头孢西丁治疗呼吸道、泌尿道需氧菌感染及口腔间隙厌氧菌感染的临床疗效、细菌学效果及安全性，并与头孢美唑对照。试验组６２例中呼吸道感染２５例、泌尿道感染２７例。口腔间隙感染１０例，细菌阳性率为８８．７％；对照组６２例中呼吸道感染２７例、泌尿道感染２５例，口腔间隙感染１０例，细菌阳性率为８３．９％。结果头孢西丁２ｇ，每日两次静脉给药治疗各系统感染的总有效率为９０．３％，细菌阴转率９２．７％，细菌清除率为９２．４％，头孢美唑组（２ｇ，每日两次静脉给药）分别为８７．１％，９０．４％和９１．５％，两药比较无明显差异。本组细菌产酶率达４０％以上，体外细菌药敏结果显示头孢西丁对需氧菌、厌氧菌的敏感率分别为９８．９％和８５．３％，与头孢美唑相近，显著优于头孢唑啉、庆大霉素及氨苄西林，对８９．６％的临床分离菌的ＭＩＣ≤１６ｍｇ／Ｌ。头孢西丁的不良反应发生率为７．９％，主要为血清转氨酶一过性升高，停药后多能自行恢复正常，头孢美唑为９．５％，两者无显著差异。

This study was designed to evaluate the clinical effectiveness and safety of cefoxitin compared with cefmetazole in treatment of respiratory, urinary tracl aerobic infeclions and oral cavity anaerobic infections. 62 patients received cefoxitin 2g intravenously twice daily for 7-14 days,25 cases with respiratory tract aerobic infections, 27 cases with urinary tract aerobic infections and 10cases with oral cavity anaerobic infections; Other 62 patients received cefmetazole 2 g intravenously twice daily for 7 - 14 days as control, 27 cases with respiratory tract aerobic infections, 25 cases with urinary tract aerobic infections and 10 cases with oral cavity anaerobic infections. The results showed that the clinical efficacy rate, bacterial efficacy raie and bacterial clerance rate of cefoxitin to 62 patients were 90.3%,92. 7% and 92.4% respectively, with no significnt difference to cefmetazole (87. 1%,90. 4% and 91.5% respectively). 125 strains were isolated in this study. cefoxitin showed susceptible to 98.9% of aerobes, and 85.3% of anaerobes, with no significant ,difference to cefmetazole, but superior to cefozolin, gentamicin and ampicillin, and 89.6% strains had a MIC lower than 16nig/L to cefoxitin in 125 strains. Slight adverse effects occured in 7. 9% patients receiving cefoxitin, while 9. 5% of control group.