头孢呋辛、头孢曲松和头孢噻肟治疗老年社区获得性肺炎的临床评价

Cefuroxime,ceftriaxone and cefotaxime sequential antibiotic therapy for community acquired pneumonia

目的比较头孢呋辛、头孢曲松和头孢噻肟治疗老年社区获得性肺炎的临床疗效、细菌清除率和安全性特点。方法采用随机、开放、对照研究的方法．78例患者分为头孢曲松组28例．采用头孢曲松注射液，静脉滴注1g·次^-1，1次·d^-1；头孢呋辛组24例，采用头孢呋辛注射液，静脉滴注1．5g·次^-1，3次·d^-1；头孢噻肟组26例，采用头孢噻肟注射液，静脉滴注2g·次^-1，3次·d^-1；疗程10-14d，评价临床疗效和细菌学疗效。结果头孢曲松和头孢噻肟组临床疗效明显优于头孢呋辛组，其差别有显著性（P〈0．05）；头孢曲松组细菌清除率是86．7％（13／15），头孢噻肟组清除率是85．7％，头孢呋辛组是62．5％，头孢曲松组和头孢噻肟组清除率明显高于头孢呋辛组（P〈0．05）。3组均未出现严重的不良反应。结论头孢曲松和头孢噻肟临床疗效及细胞清除率均优于头孢呋辛，是治疗老年社区获得性肺炎较好的药物之一。

Objective To evaluate the clinical efficacy and safety of eefuroxime, ceftriaxone and eefotaxime in the treatment of elderly patients with community acquired pneumonia （CAP）. Methods Elderly patients with CAP were treated with cefuroxime, ceftriaxone and cefotaxime in a randomized controlled study. A total of 78 patients were enrolled in this study： 24 patients in the eefuroxime group, who were treated with eefuroxirne （1 g, ivbydrip, qd） ; 28 patients in the eefuroxime group, who were treated with eefuroxime （1.5 g, ivbydrip, tid） ; and another 26 patients in the cefotaxime group, who were treated by cefotaxime （2 g, ivbydrip, tid）. Results The cure rates and the effective rates of eefuroxime, eeftriaxone and eefotaxime were 46.1%, 60. 7% and 58.3% （P〈0.05） respectively. The baete- rim eradication rates of the 3 groups were 62. 5%, 86.7% and 85.7%, （P〈0. 05） respectively. Conclusion Ceftriaxone and eefotaxime are effective and safe for elderly patients with CAP.