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口服泰利霉素每日一次共5天与莫西沙星每日一次共10天治疗急性细菌性鼻-鼻窦炎的疗效与安全性比较

Efficacy and safety of oral telithromycin once daily for 5 days versus moxifloxacin once daily for 10 days in the treatment of acute bacterial rhinosinusitis.

作者信息

Ferguson Berrylin J, Guzzetta Richard V, Spector Sheldon L, Hadley James A

机构信息

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

出版信息

Otolaryngol Head Neck Surg. 2004 Sep;131(3):207-14. doi: 10.1016/j.otohns.2004.05.010.

Abstract

OBJECTIVE

To compare the clinical and bacteriologic efficacy and safety of short-duration treatment with telithromycin given for 5 days with moxifloxacin given for 10 days in adults with acute bacterial rhinosinusitis (ABRS).

STUDY DESIGN

In this prospective, double-blind, parallel-group, randomized, multicenter study, adult patients (N = 349) with ABRS were randomized to oral telithromycin (800 mg once daily for 5 days) or to oral moxifloxacin (400 mg once daily for 10 days) and followed for 31 to 36 days. Clinical outcome was determined by the investigator at the posttherapy/test of cure (TOC) visit. Bacteriologic outcome was determined by comparing cultures taken at the pretreatment visit with cultures obtained at the posttherapy/TOC visit. The primary objective was to demonstrate equivalence of clinical cure rates in the per-protocol population between treatment groups at the posttherapy/TOC visit.

RESULTS

Clinical success at TOC (primary endpoint) was achieved in 87.4% of patients in the telithromycin group compared with 86.9% for moxifloxacin (per-protocol patients; 0.5% difference between treatment groups; 95% confidence interval [CI], -8.1, 9.2; P = 0.8930). The bacteriologic success rates were 94.1% and 93.9%, respectively (0.2% difference between treatment groups; 95% CI, -14.2, 14.5; P = 0.9734). Overall treatment-emergent adverse events for both drugs (mostly gastrointestinal) were mild to moderate in intensity.

CONCLUSION AND SIGNIFICANCE

The clinical and bacteriologic efficacy of telithromycin 800 mg once daily for 5 days was equivalent to that of moxifloxacin 400 mg once daily for 10 days, establishing telithromycin as an important treatment option for ABRS.

摘要

目的

比较在患有急性细菌性鼻窦炎(ABRS)的成人患者中,给予5天的泰利霉素短期治疗与给予10天的莫西沙星治疗的临床和细菌学疗效及安全性。

研究设计

在这项前瞻性、双盲、平行组、随机、多中心研究中,患有ABRS的成年患者(N = 349)被随机分为口服泰利霉素组(800 mg,每日一次,共5天)或口服莫西沙星组(400 mg,每日一次,共10天),并随访31至36天。临床结局由研究者在治疗后/治愈测试(TOC)访视时确定。细菌学结局通过比较治疗前访视时采集的培养物与治疗后/TOC访视时获得的培养物来确定。主要目的是证明在治疗后/TOC访视时,各治疗组符合方案人群的临床治愈率相当。

结果

泰利霉素组87.4%的患者在TOC(主要终点)时取得临床成功,而莫西沙星组为86.9%(符合方案患者;治疗组间差异为0.5%;95%置信区间[CI],-8.1,9.2;P = 0.8930)。细菌学成功率分别为94.1%和93.9%(治疗组间差异为0.2%;95% CI,-14.2,14.5;P = 0.9734)。两种药物的总体治疗中出现的不良事件(大多为胃肠道事件)强度为轻度至中度。

结论及意义

每日一次800 mg的泰利霉素治疗5天的临床和细菌学疗效与每日一次400 mg的莫西沙星治疗10天相当,确立了泰利霉素作为ABRS的一种重要治疗选择。

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