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门诊社区获得性肺炎口服加替沙星治疗:基于社区的开放标签多中心研究TeqCES的结果

Oral gatifloxacin in outpatient community-acquired pneumonia: results from TeqCES, a community-based, open-label, multicenter study.

作者信息

Gotfried Mark, Quinn Thomas C, Gothelf Samantha, Wikler Matthew A, Webb C Douglas, Nicholson Susan C

机构信息

Pulmonary Associates, Phoenix, Arizona, USA.

出版信息

Diagn Microbiol Infect Dis. 2002 Sep;44(1):85-91. doi: 10.1016/s0732-8893(02)00447-9.

Abstract

Gatifloxacin is an 8-methoxy fluoroquinolone with broad activity against respiratory tract pathogens, including those commonly associated with community-acquired pneumonia (CAP). To evaluate the efficacy and safety of oral gatifloxacin 400 mg once daily for seven to 14 days, community-based physicians enrolled adult outpatients with confirmed or suspected CAP in a prospective, single-arm, open-label, noncomparative study. Of 1488 clinically evaluable patients with radiographically confirmed or clinically suspected CAP, 1417 (95.2%) were cured. All strains of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the most commonly isolated pathogens, were susceptible to gatifloxacin. Penicillin nonsusceptibility was seen in 32.6% of S. pneumoniae isolates, and beta-lactamase production was detected in H. influenzae (26.9%) and M. catarrhalis (88%) isolates. Clinical cure rates of 91%, 94%, and 92% were achieved in patients with S. pneumoniae, H. influenzae, and M. catarrhalis, respectively. All seven patients with fully penicillin-resistant S. pneumoniae (MIC > or =2 micro g/ml) were cured. Gatifloxacin was well tolerated, with the most common drug-related adverse events being nausea (2.8%) and diarrhea (1.7%). Gatifloxacin is effective and well tolerated as empiric therapy for CAP in the outpatient community setting.

摘要

加替沙星是一种8-甲氧基氟喹诺酮类药物,对呼吸道病原体具有广泛活性,包括那些通常与社区获得性肺炎(CAP)相关的病原体。为了评估每日一次口服400mg加替沙星,疗程7至14天的疗效和安全性,社区医生在前瞻性、单臂、开放标签、非对照研究中纳入了确诊或疑似CAP的成年门诊患者。在1488例经影像学确诊或临床疑似CAP的可临床评估患者中,1417例(95.2%)治愈。最常分离出的病原体肺炎链球菌、流感嗜血杆菌和卡他莫拉菌的所有菌株均对加替沙星敏感。32.6%的肺炎链球菌分离株对青霉素不敏感,在流感嗜血杆菌(26.9%)和卡他莫拉菌('88%)分离株中检测到β-内酰胺酶产生。肺炎链球菌、流感嗜血杆菌和卡他莫拉菌患者的临床治愈率分别为91%、94%和92%。所有7例对青霉素完全耐药的肺炎链球菌(MIC≥2μg/ml)患者均治愈。加替沙星耐受性良好,最常见的药物相关不良事件为恶心(2.8%)和腹泻(1.7%)。在门诊社区环境中,加替沙星作为CAP的经验性治疗有效且耐受性良好。

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