Moxifloxacin Combined With Imipenem/Cilastatin For The Efficacy And Safety Of Severe Pneumonia In Old Age

Objective:Through retrospective research,the clinical efficacy and safety of moxifloxacin combined with Imipenem /Cilastatin in the treatment of geriatric severe pneumonia were observed,with a view to providing theoretical and clinical basis for the diagnosis and treatment of geriatric severe pneumonia.Method:Retrospectively selected 50 cases of elderly severe pneumonia patients admitted to Shang Rao Municipal Hospital from 1 January 2018 to 1 January 2020 who met the criteria for inclusion and exclusion,of which 27 were in the experimental group,23 were in the control group,and the control group was separately using Imipenem/Cilastati,and the experimental group used moxifloxacin combined with Imipenem/Cilastatin,with a treatment time of at least seven days.Collect basic information about all patients(gender,age,underlying disease,APACHE II score,albumin,C-reactive protein);compare the white blood cell count(WBC),and procalcitonin(PCT)on the first day of treatment(before treatment),the fourth and seventh days of treatment of the two groups of patients;comparing clinical efficiency on the fourth and seventh days of treatment(combined with clinical symptoms,signs,laboratory results,etc.);Comparing arterial blood gas analysis,alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(CRE)before and after treatment(pre-treatment and seventh day of treatment);Collected the results of sputum culture and mycoplasma pneumoniae antibodies,chlamydia pneumoniae antibodies and legionella pneumophila antibodies in two groups of patients;Adverse reactions associated with moxifloxacin and Imipenem /Cilastatin during treatment in two groups of patients were collected at the same time.Use SPSS 26.0 statistical software for statistical analysis.Results:Before treatment,the basic data and clinical characteristics of the two groups of patients,such as gender,age,APACHE II score(acute physiological function and chronic health score),C-reactive protein(CRP),albumin <30g/L,basic diseases≥2,were not statistically significant when compared with clinical characteristics(P-value >0.05).By evaluating and comparing the therapeutic effects of the two groups of patients by clinical symptom signs,laboratory examinations,etc.,Both groups of patients had no significant difference in efficiency on the fourth day of treatment(P>0.05).The total therapeutic efficiency of the experimental group was 88.89 percent,significantly higher than that of the control group(65.22%),and the difference was statistically significant(P<0.05).The difference between PO2,PO2/FIO2 and PO2/FIO2 before treatment and on the seventh day of treatment in the two groups was statistically significant(P-values were <0.001< Compared with the group,there was no significant difference between PO2,PO2/FIO2(P-value average >0.05)before treatment in the experimental group,no significant difference in PO2 on the seventh day of treatment in the two groups(P>0.05),and PO2/FIO2 on the seventh day of treatment in the experimental group was significantly higher than that in the control group(P<05),and the difference was statistically significant.Comparing the PCT of the first,fourth and seventh days of treatment of the two groups of patients,the difference between PCT on the first day and fourth day of treatment was not statistically significant(P>0.05),the seventh day was significantly lower than the fourth day PCT(P<0.05),and the seventh day PCT was significantly lower than the first day(P<0.05);the difference between PCT on the seventh day of treatment in the control group and the first day was not statistically significant(P>0.05).Comparing the WBC on the first,fourth and seventh days of treatment for the two groups,the decline in WBC on the first day and fourth,fourth and seventh days of treatment was not statistically significant(P-value average >0.05),while the seventh day WBC was significantly lower than the first day(P<0.05);the difference between the seventh day of WBC and the first day of treatment in the control group was not statistically significant(P>0.05).Comparison of pathogen distribution between the two groups of patients: 51.8%and 52.2% of the bacteria in the two groups,both groups of bacteria were G-based,and the detection rate of atypical bacteria in both groups was 18.52% and 17.39%,respectively,with no statistical significance(P>0.05).Adverse drug reactions associated with moxifloxacin and Imipenem /Cilastatin were collected in two groups of patients,1 case of rash in the experimental group and1 case of diarrhea in the control group.The two groups of patients were compared with ALT,AST and CRE on the seventh day of treatment,and the difference between ALT,AST and CRE on the seventh day of treatment was >0.05,and the difference was not statistically significant.Comparing P values with ALT,AST and CRE on the seventh day of treatment in the control group patients >0.05,the difference are not statistically significant.Conclusion:The clinical efficacy of moxifloxacin combined with Imipenem /Cilastatin in treating severe pneumonia in old age is better than that of the single use of Imipenem/Cilastatin,and the combined treatment of antimicrobial spectrum may be associated with moxifloxacin ability to cover atypical pathogens.Moxifloxacin combined with Imipenem /Cilastatin did not increase the occurrence of side effect compared to the treatment of severe pneumonia in old age with Imipenem /Cilastatin alone.