Grassi Carlo, Salvatori Enrica, Rosignoli Maria Teresa, Dionisio Paolo
Institute of Phthisiology and Respiratory Diseases, University of Pavia, Italy.
Respiration. 2002;69(3):217-22. doi: 10.1159/000063623.
Recently the role of bacteria in acute exacerbations of chronic bronchitis (AECB) as well as antibiotic treatment with selected drugs, especially fluoroquinolones, have been better defined.
To assess the efficacy and safety in patients with AECB of prulifloxacin in comparison with ciprofloxacin.
AECB was defined according to the guidelines for the evaluation of new anti-infective drugs for the treatment of respiratory tract infections (1992). 235 patients took part in the trial; 117 (88 males and 29 females, mean age 64.8 years) received 600 mg prulifloxacin once daily and 118 (91 males and 27 females, mean age 64.5 years) 500 mg ciprofloxacin twice a day, for a duration of 10 days. The study design was randomized, multicenter, double-blind, double-dummy. Efficacy evaluations were performed by comparing pretreatment and posttreatment assessments. The clinical response was determined by 4-point rating scores on cough, dyspnea, and expectoration (volume and appearance). The microbiological response was assessed on sputum specimen.
Clinical success was observed in 84.7 and 85% of patients in the prulifloxacin and ciprofloxacin groups, respectively. The 95% confidence interval proved the equivalence of treatments. Both drugs successfully eradicated the most commonly isolated strains, including Haemophilus influenzae, Streptococcus pneumoniae, Klebsiella pneumoniae and Pseudomonas aeruginosa. Both treatments were well tolerated. Adverse drug reactions were always of mild or moderate intensity.
The study showed that a 10-day course of prulifloxacin is as effective and safe as ciprofloxacin in the treatment of patients with AECB.
最近,细菌在慢性支气管炎急性加重(AECB)中的作用以及使用特定药物(尤其是氟喹诺酮类药物)进行抗生素治疗已得到更明确的界定。
评估与环丙沙星相比,普卢利沙星治疗AECB患者的疗效和安全性。
根据1992年呼吸道感染新抗感染药物评价指南对AECB进行定义。235名患者参与了试验;117名患者(88名男性和29名女性,平均年龄64.8岁)每天服用一次600毫克普卢利沙星,118名患者(91名男性和27名女性,平均年龄64.5岁)每天服用两次500毫克环丙沙星,疗程为10天。研究设计为随机、多中心、双盲、双模拟。通过比较治疗前和治疗后的评估进行疗效评价。临床反应通过对咳嗽、呼吸困难和咳痰(量和外观)的4分制评分来确定。微生物反应通过痰液标本进行评估。
普卢利沙星组和环丙沙星组分别有84.7%和85%的患者临床治疗成功。95%置信区间证明了两种治疗方法的等效性。两种药物均成功根除了最常见的分离菌株,包括流感嗜血杆菌、肺炎链球菌、肺炎克雷伯菌和铜绿假单胞菌。两种治疗方法耐受性良好。药物不良反应始终为轻度或中度。
该研究表明,在治疗AECB患者时,10天疗程的普卢利沙星与环丙沙星一样有效且安全。