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莫西沙星(拜复乐)对严重中性粒细胞减少患者感染的预防效果

[Efficacy of moxifloxacin (Avelox) in prophylaxis of infection in patients with profound neutropenia].

作者信息

Minenko S V, Dmitrieva N V, Sokolova E N, Zhukov N V, Ptushkin V V

出版信息

Antibiot Khimioter. 2004;49(3):26-31.

Abstract

Comparative efficacy of moxifloxacin and ciprofloxacin as prophylactics of infection in cancer patients with severe neutropenia after the chemotherapy was studied. The study included 40 patients with malignant lymphomas and solid tumore who received 52 courses of the aggressive chemotherapy. Twenty four patients (30 courses) received oral moxifloxacin in a dose of 400 mg once a day from the first day of the neutrophil count decrease below 1.0 x 10(9)/l until its recovery to > 1.0 x 10(9)/l or when the signs of infection appeared. In the control group 16 patients (22 courses) received oral ciprofloxacin in a dose of 500 mg twice a day. The patients in both the groups were compatible by the diagnosis, age and neutropenia duration. The median of the days of the febrile neutropenia duration in the patients prophylactically treated with moxifloxacin was statistically lower (2.1 vs 3.6 in the control group, p < 0.05). The incidence of febrile neutropenia in the moxifloxacin group was significantly lower than that in the control group (73 and 100% respectively, p = 0.01). The incidence of bacteriologically confirmed infection in the moxifloxacin group was also lower (6% vs 27.2%, p = 0.04). Therefore, moxifloxacin proved to be a more efficient agent vs ciprofloxacin (standard prophylactic) in prevention of febrile neutropenia and neutropenic infection in cancer patients, which is likely due to its higher activity against grampositive organisms.

摘要

研究了莫西沙星和环丙沙星作为化疗后严重中性粒细胞减少症癌症患者感染预防药物的比较疗效。该研究纳入了40例恶性淋巴瘤和实体瘤患者,他们接受了52个疗程的强化化疗。24例患者(30个疗程)从中性粒细胞计数降至低于1.0×10⁹/L的第一天起,每天口服一次400mg莫西沙星,直至中性粒细胞计数恢复至>1.0×10⁹/L或出现感染迹象。对照组16例患者(22个疗程)每天口服两次500mg环丙沙星。两组患者在诊断、年龄和中性粒细胞减少持续时间方面具有可比性。接受莫西沙星预防性治疗的患者发热性中性粒细胞减少持续天数的中位数在统计学上较低(对照组为2.1天对3.6天,p<0.05)。莫西沙星组发热性中性粒细胞减少的发生率显著低于对照组(分别为73%和100%,p=0.01)。莫西沙星组细菌学确诊感染的发生率也较低(6%对27.2%,p=0.04)。因此,在预防癌症患者发热性中性粒细胞减少和中性粒细胞减少性感染方面,莫西沙星被证明是一种比环丙沙星(标准预防药物)更有效的药物,这可能是由于其对革兰氏阳性菌具有更高的活性。

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