Minov Jordan, Stoleski Sasho, Petrova Tatjana, Vasilevska Kristin, Mijakoski Dragan, Bislimovska-Karadzhinska Jovanka
Institute for Occupational Health of Republic of Macedonia-WHO Collaborating Center and GA2LEN Collaborating Center, Skopje, Republic of Macedonia.
Department of Pharmacy Practice, Chicago State University, Chicago, IL, USA.
Open Access Maced J Med Sci. 2018 Nov 7;6(11):2017-2022. doi: 10.3889/oamjms.2018.445. eCollection 2018 Nov 25.
Bacterial infections are involved in more than a half of the exacerbations of chronic obstructive pulmonary disease (COPD).
To evaluate the efficacy and safety of moxifloxacin in the outpatient treatment of moderate exacerbations of bacterial origin in the COPD patients.
We performed a prospective, observational study including 64 COPD patients with moderate exacerbation of bacterial origin empirically treated with moxifloxacin. In 31 of them, moxifloxacin was used as an initial antibiotic (Group 1), whereas in 33 of them moxifloxacin was used after treatment failure with another antibiotic (Group 2). All patients have treated 7 days with moxifloxacin 400 mg once daily per os, and they were followed up for 20 days, with an intermediate visit at 3, 5 and 7 days at which the duration of symptoms and the side effects of the drug were evaluated.
We registered high clinical success rate, i.e. the complete resolution of the symptoms or their return to the baseline severity, similar in both groups (84.3% in all study subjects, 83.9% in the Group 1 and 84.8% in the Group 2). The mean time to complete resolution of the cardinal symptoms or their return to the baseline severity was 5.2 ± 1.1 days. Also, the mean time to complete resolution of the certain cardinal symptoms (increased dyspnea, increased sputum volume and increased sputum purulence) or their return to the baseline severity is given 4.9, 4.7 and 4.2 days, respectively. The incidence of adverse effects during the treatment with moxifloxacin in all study subjects was 10.9%, 9.6% in Group 1 and 12.1% in Group 2. There was no serious adverse effect that required discontinuation of the treatment. Relapse during a 20 days follow-up period was registered in 7.4% of the all study subjects with complete resolution of the cardinal symptoms or their return to the baseline severity, i.e. in two patients from both Group 1 and Group 2 (7.6% and 7.1%, respectively). 4.
Our findings suggest high efficacy and good tolerability of moxifloxacin in the treatment of moderate COPD exacerbations of bacterial origin.
细菌感染参与了超过一半的慢性阻塞性肺疾病（COPD）急性加重。
评估莫西沙星门诊治疗COPD患者细菌性中度急性加重的疗效和安全性。
我们进行了一项前瞻性观察性研究，纳入64例细菌性中度急性加重的COPD患者，经验性使用莫西沙星治疗。其中31例，莫西沙星用作初始抗生素（第1组），而另外33例在使用另一种抗生素治疗失败后使用莫西沙星（第2组）。所有患者口服莫西沙星400mg每日1次，共治疗7天，并随访20天，在第3、5和7天进行中间访视，评估症状持续时间和药物副作用。
我们记录到高临床成功率，即症状完全缓解或恢复到基线严重程度，两组相似（所有研究对象中为84.3%，第1组为83.9%，第2组为84.8%）。主要症状完全缓解或恢复到基线严重程度的平均时间为5.2±1.1天。同样，某些主要症状（呼吸困难加重、痰液量增加和痰液脓性增加）完全缓解或恢复到基线严重程度的平均时间分别为4.9、4.7和4.2天。所有研究对象在莫西沙星治疗期间不良反应发生率为10.9%，第1组为9.6%，第2组为12.1%。没有严重不良反应需要停药。在20天随访期内，所有主要症状完全缓解或恢复到基线严重程度的研究对象中有7.4%复发，即第1组和第2组各有2例患者（分别为7.6%和7.1%）。
我们的研究结果表明莫西沙星治疗细菌性COPD中度急性加重疗效高且耐受性良好。
