1 Department of Respiratory disease, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China ; 2 Laboratory of Respiratory Disease of Fujian Medical University, Fuzhou 350005, China ; 3 Department of Neurology, Fujian Geriatric Hospital, Fuzhou 350003, China ; 4 Department of Respiratory Medicine, Huadong Hospital, Shanghai Medical School of Fudan University, Shanghai 200040, China ; 5 Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai Medical School of Fudan University, Shanghai 200032, China.
J Thorac Dis. 2014 Mar;6(3):221-9. doi: 10.3978/j.issn.2072-1439.2013.11.12.
To evaluate the efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis (AECB) and chronic obstructive pulmonary disease (AECOPD).
We searched PubMed, EMBASE, and the Web of Science for relevant studies. Two reviewers extracted data and reviewed the quality of the studies independently. The primary outcome was clinical success at early follow-up. Study-level data were pooled using a random-effects model when I(2) was >50% or a fixed-effects model when I(2) was <50%.
Eleven randomized controlled studies were considered. There was no difference between moxifloxacin and comparator agents with regard to treatment success in intention-to-treat (ITT) [odds ratio (OR) =1.18, 95% confidence interval (CI) 0.98-1.42], clinically evaluable (CE) (OR 1.13, 95% CI, 0.93-1.37) patients, or adverse effects in general (OR 1.00, 95% CI, 0.86-1.17). Moxifloxacin was associated with better microbiological success (OR 1.45; 95% CI, 1.14-1.85).
Moxifloxacin was as clinically equivalent and bacteriologically superior to the antibiotic regimens routinely used in patients with AECB and AECOPD. Moxifloxacin therapy may be a promising and safe alternative to empirical treatment for AECB and AECOPD.
评估莫西沙星治疗慢性支气管炎急性加重（AECB）和慢性阻塞性肺疾病急性加重（AECOPD）的疗效和安全性。
我们检索了 PubMed、EMBASE 和 Web of Science 中的相关研究。两位评审员独立提取数据并评估研究质量。当 I²>50%时，使用随机效应模型汇总研究水平数据；当 I²<50%时，使用固定效应模型汇总研究水平数据。
共纳入 11 项随机对照研究。意向治疗（ITT）[比值比（OR）=1.18，95%置信区间（CI）0.98-1.42]、可临床评估（CE）（OR 1.13，95%CI，0.93-1.37）患者以及一般不良事件（OR 1.00，95%CI，0.86-1.17）方面，莫西沙星与对照药物治疗成功率无差异。莫西沙星在微生物学疗效方面更优（OR 1.45；95%CI，1.14-1.85）。
莫西沙星在治疗 AECB 和 AECOPD 方面与常规抗生素方案疗效相当，且在细菌学方面具有优势。莫西沙星治疗可能是 AECB 和 AECOPD 经验性治疗的一种有前景且安全的替代方案。
