| 摘要: |
| ［摘要］目的 评价昆明当地耐药谱抗生素与国外社区获得性肺炎（CAP）诊治指南推荐备选方案治疗CAP患者的抗菌疗效．方法 采用前瞻性、随机、单盲、阳性药平行对照设计．以无基础疾病的门诊和入院＜48 h的CAP患者为研究对象，试验组给予当地耐药谱中的敏感抗生素：莫西沙星片，400 mg，每日1次；对照组给予2007年版IDSA/ATS颁布的成人CAP诊治指南备选方案中的首选抗生素：阿奇霉素片，每次500 mg，每日1次．结果 共收集CAP患者106例，完成治疗方案77例，试验组39例，对照组38例．2组临床有效率分别为89.7%和68.4%，2组临床疗效差异有统计学意义（P＜0.01）；2组细菌清除率分别为87.9%和54.5%（P＜0.05）．结论 昆明地区耐药谱敏感抗生素治疗当地无基础疾病的社区获得性肺炎的临床疗效优于IDSA/ATS指南推荐方案抗生素．临床医师在学习和参考国外的指南时，应注重我国CAP常见病原菌的耐药特征和构成状况，并结合当地耐药监测资料的变化加以修正和调整，不宜简单照搬国外指南所推荐的治疗方案． |
| 关键词: ［关键词］社区获得性肺炎 国外指南 当地耐药谱 |
| DOI： |
| 分类号: |
| 基金项目:［基金项目］云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目（2013FB145） |
|
| Evaluation of Antimicrobial Efficacy of Local Drug Resistance Spectrum Antibiotics and Foreign Guideline on Community Acquired Pneumonia |
|
LI Jian-hua
|
|
（Dept. of Respiratory Medicine，The1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China）
|
| Abstract: |
| ［Abstract］Objective To evaluate the clinical efficacy of the local drug resistance spectrum antibiotics and foreign guideline in the treatment of patients with community acquired pneumonia（CAP）. Methods A prospective，randomized，single blind，and positive drug parallel controlled design was used in the treatment. CAP patients with no underlying disease outpatients and inpatients＜48 hours were selected as the research object. The patients in the trial group were given sensitive local drug resistance spectrum antibiotics: moxifloxacin，400 mg and 1 times a day. The patients in the control group were given azithromycin tablets（each 500 mg，once daily） promulgated by the 2007 version of the IDSA / ATS adult CAP guideline. Results There were 106 cases of CAP patients， of which 77 cases completed treatment， including 39 cases in the experimental group and 38 cases in the control group. There were significant differences in the clinical efficacy and bacterial clearance rate between the two groups， with the clinical efficacy of 89.7% and 68.4%（P < 0.01），the bacterial clearance rate of 87.9% and 54.5%（P < 0.05）， respectively. Conclusion The clinical efficacy of drug resistant spectrum sensitive antibiotics in the treatment of CAP in Kunming was better than that of IDSA/ATS. Clinicians should pay attention to the characteristics and composition of resistance of common pathogenic bacteria in our country during the study and reference from foreign guideline，and adjust the therapeutic regimen according to the changes of the local drug resistance monitoring data rather than copy the recommended treatment plan by foreign countries. |
| Key words: ［Key words］Community acquired pneumonia Guidelines abroad Local resistance spectrum |