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硫酸多粘菌素B/甲氧苄啶滴眼液与莫西沙星治疗细菌性结膜炎临床疗效速度的多中心比较

A multicenter comparison of polymyxin B sulfate/trimethoprim ophthalmic solution and moxifloxacin in the speed of clinical efficacy for the treatment of bacterial conjunctivitis.

作者信息

Granet David B, Dorfman Mark, Stroman David, Cockrum Paul

机构信息

Ratner Children's Eye Center, University of California-San Diego, La Jolla, California, USA.

出版信息

J Pediatr Ophthalmol Strabismus. 2008 Nov-Dec;45(6):340-9. doi: 10.3928/01913913-20081101-07.

Abstract

PURPOSE

To compare the speed of clinical efficacy for two currently available topical antibiotics: polymyxin B sulfate/trimethoprim (polymyxin/trimethoprim) and 0.5% moxifloxacin ophthalmic solution.

METHODS

Eighty-four eyes of 56 patients younger than 18 years with a clinical diagnosis of bacterial conjunctivitis were enrolled in this multicenter study. Patients were randomly assigned to receive either 1 drop of polymyxin/trimethoprim four times daily for 7 days or 1 drop of 0.5% moxifloxacin three times daily for 7 days. Ocular signs and symptoms were evaluated at baseline and 24 and 48 hours after the start of dosing. Microbiological cultures were collected at baseline and 48 hours. Patients rated ocular symptoms and adverse events on day 7 via telephone interview. Primary efficacy assessment included relief of all signs and symptoms of bacterial conjunctivitis.

RESULTS

All patients but one completed all visits. At the 48-hour visit, complete resolution of ocular signs and symptoms was observed in 81% of the patients treated with moxifloxacin and 44% of the patients treated with polymyxin/trimethoprim (P = .001). No adverse events were reported.

CONCLUSION

Moxifloxacin 0.5% administered three times daily is safe and cures bacterial conjunctivitis more effectively and significantly faster than polymyxin/trimethoprim dosed four times daily. The majority of patients were cured and symptom-free by 48 hours. Therefore, moxifloxacin is cost-effective and significantly more efficacious than polymyxin/trimethoprim in the speed by which it reduces the symptoms and disease transmission.

摘要

目的

比较两种目前可用的局部用抗生素——硫酸多粘菌素B/甲氧苄啶(多粘菌素/甲氧苄啶)和0.5%莫西沙星滴眼液的临床疗效速度。

方法

本多中心研究纳入了56例年龄小于18岁、临床诊断为细菌性结膜炎的患者的84只眼。患者被随机分配,分别接受每日4次、每次1滴多粘菌素/甲氧苄啶,共7天,或每日3次、每次1滴0.5%莫西沙星,共7天。在基线以及给药开始后24小时和48小时评估眼部体征和症状。在基线和48小时采集微生物培养样本。在第7天通过电话访谈让患者对眼部症状和不良事件进行评分。主要疗效评估包括细菌性结膜炎所有体征和症状的缓解情况。

结果

除1例患者外,所有患者均完成了所有访视。在48小时访视时,接受莫西沙星治疗的患者中有81%的眼部体征和症状完全消退,接受多粘菌素/甲氧苄啶治疗的患者中这一比例为44%(P = 0.001)。未报告不良事件。

结论

每日3次使用0.5%莫西沙星安全,且比每日4次使用多粘菌素/甲氧苄啶更有效,能显著更快地治愈细菌性结膜炎。大多数患者在48小时时治愈且无症状。因此,莫西沙星在减轻症状和疾病传播速度方面比多粘菌素/甲氧苄啶更具成本效益且疗效显著更高。

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