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題 名 | An Open-label, Randomized Comparison of Levofloxacin and Amoxicillin/Clavulanate Plus Clarithromycin for the Treatment of Hospitalized Patients with Community-acquired Pneumonia=開放性、隨機的方式比較評估可樂必妥 (Levofloxacin) 相較於安滅菌 (Amoxicillin/Clavulanate) 合併開羅理黴素 (Clarithromycin) 於治療需住院的社區性肺炎 |
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作 者 | 林定佑; 林恕民; 陳豪成; 王志冉; 王郁閔; 張敏麗; 王圳華; 劉劍英; 林鴻銓; 余志騰; 謝玲玲; 郭漢彬; 黃建達; | 書刊名 | 長庚醫學 |
卷 期 | 30:4 2007.07-08[民96.07-08] |
頁 次 | 頁321-332 |
分類號 | 418.281 |
關鍵詞 | 社區感染肺炎; 臨床試驗; 年長的; 氟化奎林酮類抗生素; 可樂必妥; Community-acquired pneumonia; Clinical trial; Elderly; Fluoroquinolones; Levofloxacin; |
語 文 | 英文(English) |
中文摘要 | 背景:由於其廣泛的抗菌範圍,抗肺炎球菌的氟化奎林酮類抗生素已常用於治療社區感染的肺炎。 方法:一項開放性、隨機的研究在一個第三級教學醫院進行。合適的病人隨機分成以可樂必妥針劑每日 500毫克,接著換成口服 每日500毫克,或每日每8小時以500毫克/125毫克安滅菌針劑及250毫克/125毫克膜衣錠合併每日12 小時500毫克開羅理黴 素膜衣錠。整個治療時間至少為七至十四天。 結果:從西元2004年七月至西元2006年二月,五十位病人符合條件並加入研究 (可樂必妥,26人;合併治療,24人)。 兩組的臨 床反應率相似(78.3% vs. 77.3%;p=1.000)。可樂必妥在對所有的微生物,格蘭氏陰性菌以及非假單胞菌 (non-pseudomonas)之格蘭氏陰性菌有較高的微生物學反應率(60%vs.38.9%;55.0%vs.21.0%and 75.0%vs.25.0%)但無統計 學上的差異。兩組的住院天數是相似的(7.4+3.1vs.6.8+2.1days;p=1.000)。 結論:因社區感染肺炎至本院住院的病人,年齡較高,合併症較多,有較高的比率感染格蘭氏陰性菌肺炎。可樂必妥至少和安滅 菌加開羅理黴素的合併治療在臨床反應率和微生物學反應率一樣有效。可樂必妥有比合併治療較高的滅菌效果但無統計學 上的差異,需要更多病人數的進一步試驗證實。 |
英文摘要 | Background: Anti-pneumococcal fluoroquinolone has been used to treat community-acquired pneumonia (CAP) frequently because of its broad antimicrobial spectrum. Methods: This randomized, open-label study was conducted in a tertiary teaching hospital. Eligible patients were randomized to levofloxacin 500 mg IV q24h followed by 500 mg orally q24h or a combination of amoxicillin/clavulanate 500 mg/100 mg IV q8h with oral clarithromycin 500 mg q12h and then oral amoxicillin/clavulanate 250 mg/125 mg q8h with oral clarithromycin 500 mg q12h for 7-14 days. Results: From July 2004 to February 2006, 50 patients were enrolled (levofloxacin, n = 26; combination therapy, n = 24). The clinical response rate in the clinically evaluable population was similar for both groups (78.3% vs. 77.3%; p = 1.000). Levofloxacin had a higher microbiological response rate overall, and for Gram-negative and non-pseudomonas Gram-negative pathogens than the combination therapy but the difference was not statistically significant (60.0% vs. 38.9%, 55.0% vs. 21.0% and 75.0% vs. 25.0%, respectively). The length of hospital stay was similar for both groups (7.4 3.1 vs. 6.8 2.1 days; p = 1.000). Conclusion: Patients who were admitted to our hospital for CAP were older and had more comorbidities with a much higher incidence of Gram-negative pathogens than in a previous study. Levofloxacin was at least as effective as amoxicillin/clavulanate plus clarithromycin in clinical and microbiological responses. Levofloxacin had a higher microbiological eradication rate than the combination therapy but the difference was not statistically significant. This deserves further study with a larer sample size. |
本系統中英文摘要資訊取自各篇刊載內容。