| Community-acquired pneumonia(CAP)is one of the common infectious diseases of the elderly.The use of antibiotics has caused the mortality rate of CAP to decline for some time.In recent years,even the emergence of effective vaccines and the use of antibiotics with greater efforts,the mortality rate of CAP was higher than before.Due to the decrease of the elderly patients’ autoimmune immunity,the decrease in lung function,and the combination of basic diseases,the morbidity and mortality of elderly patients with CAP are increasing.Therefore,accurate and objective evaluation of the severity of CAP in elderly patients and the establishment of effective and reasonable treatment plans as soon as possible are the key to the management of elderly patients with CAP.In the treatment of elderly patients with CAP,drug metabolism is poor,drug-related adverse reactions are prone to occur,and drug safety is the focus of attention.Therefore,we must not only choose the type of antibiotics rationally,but the choice of its administration method also has an important influence on the treatment.At present,the choice of antibiotic administration methods has not been completely unified.In patients with effective initial treatment,sustainable intravenous infusion of a antibiotic can be given to patients,sequential therapy can also being given.but the advantage and disadvantage are not known.The purpose of this study was to investigate the efficacy and safety of moxifloxacin sequential therapyfor elderly patients with CAP,and to provide the basis for the selection of the best treatment plan for elderly patients with CAP.Objective:To use moxifloxacin in the treatment of elderly patients with CAP with effective initial treatment for anti-infective therapy with different modes of administration,and to compare the clinical efficacy,changes in inflammatory parameters,imaging changes,and hospitalization costs,adverse reactions between the two groups after treatment.Providing reference for the choice of treatment options.Methods:154 elderly patients with non-severe CAP who were effective in initial treatment by intravenous infusion of moxifloxacin(0.4g,once daily)in the First Hospital of Jilin University between January 2017 and August 2017 were randomly divided into two groups: one group continued to be intravenously infused moxifloxacin to 10 days,defined as the control group.one group were followed by Sequential oral moxifloxacin(moxifloxacin 0.4g,once daily)to 10 th after intravenous infusion of moxifloxacin for 5 days,defined as the observation group.one month later,the two groups of patients were followed up,and compared the differences of the inflammatory markers,imaging changes,clinical efficacy,treatment costs,and adverse reactions between the two groups.Results:1.Comparison of clinical symptoms and physical signs: At the end of 10 days of treatment,the clinical symptoms and signs of the two groups were significantly improved compared with those beforetreatment.The difference was statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05).2.Comparison of Inflammation Indexes: At the end of 10 days of treatment,the white blood cells,PCT,CRP,and ESR of the two groups were significantly improved compared with those before treatment(P<0.05),but there was no statistical difference between the two groups(P>0.05).After one month follow-up,there was no significant difference in white blood cells,PCT,CRP and ESR between the two groups(P>0.05).3.Comparison of lung CT : there was no significant difference in the rate of pulmonary CT inflammatory absorption between the observation group and the control group at the end of treatment 10 days(P>0.05).After one month follow-up,there was no statistical difference in CT imaging between the two groups(P>0.05).4.Comparison of Clinical Efficacy: At the end of the 10 days of treatment,there was no significant difference in clinical efficacy between the two groups(P>0.05).After one month follow-up,the clinical efficacy of both groups was significantly higher than the end of treatment,and the difference was statistically significant(P<0.05).However,the difference in efficacy between the two groups was no statistically significant(P>0.05).5.Comparison of treatment costs: At the end of treatment,hospitalization expenses and drug costs in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).6.Comparison of adverse reactions: The incidence of adversereactions in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:1.Compared with continuous infusion of moxifloxacin for elderly patients with non-severe CAP,the curative effect of sequential therapy is comparable,providing a more reasonable treatment plan for clinical work.2.Compared with continuous intravenous infusion of moxifloxacin in elderly patients with non-severe CAP,sequential therapy reduces the incidence of adverse drug reactions and treatment costs,reducing hospitalization time,and is worthy of clinical application. |
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