莫西沙星单药治疗成人复杂腹腔感染的疗效分析

Moxifloxacin monotherapy in the treatment of adult patients with complicated intra-abdominal infection

目的成人复杂腹腔感染为各种原因导致的多种细菌混合感染,通过研究莫西沙星在成人复杂腹腔感染中的临床疗效、安全性,为临床治疗成人复杂腹腔感染提供参考。方法前瞻性选择2017年1月至2019年1月符合纳入标准的成人复杂腹腔感染病例,采用数字抽签法随机分为莫西沙星组(盐酸莫西沙星注射液20 ml加入5%葡萄糖注射液或生理盐水250 ml中,静脉滴注,每天1次)和对照组(头孢他啶加入2.0 g 100 ml生理盐水中,静脉滴注,每8小时给药1次;0.5%甲硝唑氯化钠注射液100 ml静脉滴注,每12小时给药1次),均连续应用7~14 d。比较两组药物在疗效判定访视时(治疗结束后1~7 d)的有效性,对比不良反应。结果共纳入110例患者,莫西沙星组53例,细菌培养阳性40例,对照组57例,细菌培养阳性42例,两组患者人口学及临床特征相似(P均>0.05)。莫西沙星组临床治愈率96.2%(51/53),细菌清除率95.0%(38/40);对照组临床治愈率96.5%(55/57),细菌清除率95.2%(40/42),差异无统计学意义(P均>0.05)。两组药物不良反应主要为恶心及低钾血症,发生率差异无统计学意义(P均>0.05),且均无严重不良事件发生。结论对于成人复杂腹腔感染,莫西沙星单药治疗有效,相对安全,且便捷;不良反应与使用多年的头孢他啶及甲硝唑相近。

Objective Adult complicated intra-abdominal infection(cIAI)are multiple bacterial mixed infections caused by various reasons.To study the clinical efficacy and safety of moxifloxacin in the treatment of cIAI in adults to provide reference in the clinical practice.Methods The cIAI patients met inclusion criteria were prospectively selected from January 2017 to January 2019 and randomly divided into moxifloxacin group and control group.In moxifloxacin group,moxifloxacin hydrochloride injection 20 ml was added into 5%glucose solution or of normal saline 250 ml for intravenous drip once a day.In control group,2.0 g ceftazidime was added into 100 ml normal saline for intravenous drip once every 8 hours,and 0.5%metronidazole sodium chloride 100 ml was given by intravenous drip once every 12 hours.Both groups were administered continuously for 7-14 days.At 1-7 days after the end of treatment,the therapeutic efficacy and adverse reactions were compared between two groups.Results A total of 110 patients were enrolled,53 cases in moxifloxacin group,and 40 cases were positive for bacterial culture;57 cases in control group and 42 cases were positive for bacterial culture.The demographic and clinical characteristics were similar in two groups(all P>0.05).There were no significant differences in clinical cure rate[96.2%(51/53)vs 96.5%(55/57)]and the bacterial clearance rate[95.0%(38/40)vs 95.2%(40/42)]between moxifloxacin group and control group and in the incidence of adverse reactions(mainly nausea and hypokalemia)between two groups(all P>0.05).No serious adverse events occurred in two groups.Conclusion In the treatment of cIAI in adults,moxifloxacin monotherapy is effective,safe and convenient,and with adverse reactions similar to those of ceftazidime and metronidazole.