Muijsers Richard B R, Jarvis Blair
Adis International Limited, Auckland, New Zealand.
Drugs. 2002;62(6):967-73; discussion 974-5. doi: 10.2165/00003495-200262060-00008.
Moxifloxacin is a fluoroquinolone antibacterial agent which attains good penetration into peripheral tissues and inflammatory fluids. The drug shows good in vitro activity against staphylococci and streptococci. Moxifloxacin is therefore a suitable option for the treatment of uncomplicated skin and skin structure infections of bacterial origin. In clinical trials, moxifloxacin was as effective as cephalexin in the treatment of uncomplicated skin and skin structure infections in patients aged >or=18 years. Moxifloxacin 400mg once daily or cephalexin 500mg three times daily for 7 days both resulted in clinical resolution in 84% of patients during a double-blind, randomised trial in 401 patients (intent-to-treat). The main infectious agent in this study was Staphylococcus aureus. Similar results were obtained in two other randomised, double-blind trials published as abstracts. The bioavailability of moxifloxacin is substantially reduced by coadministration with antacids or iron preparations. Moxifloxacin, however, does not show pharmacokinetic interaction with theophylline or warfarin. Dosage adjustments are not required in patients with renal impairment or in patients with mild to moderate hepatic insufficiency. The most common adverse events reported during moxifloxacin treatment are gastrointestinal disturbances. The potential for photosensitivity reactions during moxifloxacin treatment is low.
莫西沙星是一种氟喹诺酮类抗菌药物,可很好地渗透到外周组织和炎性液体内。该药对葡萄球菌和链球菌显示出良好的体外活性。因此,莫西沙星是治疗非复杂性细菌性皮肤及皮肤结构感染的合适选择。在临床试验中,莫西沙星在治疗≥18岁患者的非复杂性皮肤及皮肤结构感染方面与头孢氨苄疗效相当。在一项针对401例患者的双盲、随机试验(意向性治疗)中,莫西沙星每日一次400mg或头孢氨苄每日三次500mg,连用7天,均使84%的患者获得临床治愈。本研究中的主要感染病原体为金黄色葡萄球菌。在另外两项作为摘要发表的随机、双盲试验中也获得了类似结果。莫西沙星与抗酸剂或铁制剂合用时生物利用度会大幅降低。不过,莫西沙星与茶碱或华法林不存在药代动力学相互作用。肾功能损害患者或轻度至中度肝功能不全患者无需调整剂量。莫西沙星治疗期间报告的最常见不良事件为胃肠道不适。莫西沙星治疗期间发生光敏反应的可能性较低。