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【科普】喹诺酮类利于重症社区获得性肺炎
NEW YORK (Reuters Health) Jan 01 - Certain fluoroquinolones achieve better results in patients with severe forms of community-acquired pneumonia than does treatment with beta-lactams and macrolides, according to a meta-analysis reported in the December 2nd issue of the Canadian Medical Association Journal.
"The main finding of our study," senior investigator Dr. Matthew E. Falagas told Reuters Health, "is that fluoroquinolones with activity against respiratory pathogens were associated with a better rate of cure in patients with community-acquired pneumonia."
Dr. Falagas of the Alfa Institute of Biomedical Sciences, Athens, Greece, and colleagues came to this conclusion after studying data from 23 published clinical trials involving more than 7000 patients.
The trials compared fluoroquinolones -- levofloxacin, moxifloxacin, or gemifloxacin -- with macrolides or beta-lactams or both.
The overall treatment success rate was high for fluoroquinolones (84.2%) and for the comparator antibiotics (82.2%).
Pneumonia resolved in more of the patients who received fluoroquinolones. This amounted to an odds ratio of 1.17 in intention-to-treat analysis. In the population available for clinical evaluation, the corresponding ratio was 1.26. In microbiologically assessed patients, it was 1.67.
Fluoroquinolones were more effective compared with combination therapy (odds ratio, 1.39). They were also more effective in the subgroup of patients with severe pneumonia (odds ratio, 1.84); those who required hospital admission (odds ratio, 1.30); as well as those who required intravenous therapy (odds ratio, 1.44).
Although there were no between-group differences in mortality, the effect of fluoroquinolones was most prominent among the sickest patients, with a 9% absolute difference in treatment success.
"I believe that this class of antibiotics should be especially considered in patients with severe forms of community-acquired pneumonia," Dr. Falagas concluded.
喹诺酮类利于重症社区获得性肺炎
（纽约路透电）1月1日-某些氟喹诺酮类药物比β-内酰胺类和大环内酯类抗生素治疗重症社区获得性肺炎取得更好的效果，根据加拿大医学协会12月2日杂志Meta分析报告。
高级研究员Falagas博士告诉路透社记者，“我们研究的主要结果显示氟喹诺酮类药物具有抗呼吸道病原体活性，这是其治疗社区获得性肺炎治愈率更好的原因”。
希腊雅典阿尔法生物医学科学研究所Falagas博士和同事研究了涉及7000多名患者的23项临床试验数据后得出这一结论。
试验比较了氟喹诺酮-盐酸左氧氟沙星、莫西沙星或吉米沙星-与大环内酯类抗生素或β-内酰胺类或两者联合。
氟喹诺酮和比较抗生素总的治疗成功率高(84.2% 和82.2%)。
喹诺酮类治疗的病人肺炎得到更好的改善，意向治疗分析总计优势比1.17。在供临床评价的人群，相应比率为1.26；在微生物评估的病人是1.67。
氟喹诺酮类药物比综合治疗更有效（OR值1.39），在重症肺炎亚群（OR 1.84）、需要入院（OR 1.30）以及需要静脉注射治疗患者（OR 1.44）氟喹诺酮类也更有效。
虽然死亡率没有组间差异，氟喹诺酮对最严重患者效应最突出，治疗成功差额为9％。
Falagas博士总结道，“我认为该类抗生素尤其应考虑用于严重社区获得性肺炎患者，”
CMAJ 2008;179:1269-1277. [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-24 05:12
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