Jones Ronald N, Andes David R, Mandell Lionel A, Gothelf Samantha, Ehrhardt Anton F, Nicholson Susan C
The JONES Group/JMI Laboratories, North Liberty, Iowa, USA.
Diagn Microbiol Infect Dis. 2002 Sep;44(1):93-100. doi: 10.1016/s0732-8893(02)00448-0.
Gatifloxacin is an advanced-generation fluoroquinolone with demonstrated efficacy and safety as therapy for community-acquired pneumonia (CAP). As part of a phase IV postmarketing surveillance program (TeqCES), 136 outpatients with CAP whose sputum was culture-positive for Streptococcus pneumoniae were enrolled in an open-label trial of oral gatifloxacin 400 mg daily for 7 to 14 days. An antibiogram of isolates showed 100% susceptibility to gatifloxacin (MIC(90) 0.5 micro g/mL) and respective susceptibilities of 67%, 70%, and 80% to penicillin, erythromycin, and tetracycline. Clinical cure was achieved in 95.3% of evaluable patients, including seven patients infected with penicillin-resistant S. pneumoniae (MIC > or =2 micro g/mL). The bacteriologic eradication rate for S. pneumoniae was 94.5%. Diarrhea, nausea, and dizziness, the most common adverse events in CAP patients (<3%), were generally mild to moderate; no serious adverse events were recorded. These results support recommendations to treat CAP, particularly due to S. pneumoniae including multidrug-resistant strains, with the newer 8-methoxy-fluoroquinolone, gatifloxacin.
加替沙星是新一代氟喹诺酮类药物,已证明其作为社区获得性肺炎(CAP)治疗药物的有效性和安全性。作为IV期上市后监测项目(TeqCES)的一部分,136例痰培养肺炎链球菌阳性的CAP门诊患者参加了一项开放标签试验,口服加替沙星400mg,每日1次,疗程7至14天。分离菌株的抗菌谱显示对加替沙星100%敏感(MIC(90)0.5μg/mL),对青霉素、红霉素和四环素的敏感率分别为67%、70%和80%。95.3%的可评估患者获得临床治愈,其中包括7例感染耐青霉素肺炎链球菌(MIC≥2μg/mL)的患者。肺炎链球菌的细菌清除率为94.5%。腹泻、恶心和头晕是CAP患者最常见的不良事件(<3%),一般为轻至中度;未记录到严重不良事件。这些结果支持使用新一代8-甲氧基氟喹诺酮类药物加替沙星治疗CAP,尤其是由肺炎链球菌包括多重耐药菌株引起的CAP。