Efficacy Of Moxifloxacin In The Treatment Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease In Elderly Patients Without Risk Factors Of Pseudomonas Aeruginosa Infection

Objective:Objective to investigate the clinical value of moxifloxacin in the treatment of acute exacerbation of chronic obstructive pulmonary disease without risk factors of Pseudomonas aeruginosa infection,and to evaluate its efficacy and safety.Methods:From December 2018 to January 2020,130 patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into experimental group and control group.Moxifloxacin or amoxicillin/clavulanic acid were added to oxygen,systemic corticosteroids,bronchodilator,expectorant and other adjuvant drugs.The efficacy and laboratory indexes were evaluated after treatment.Results:In terms of clinical efficacy,the effective rate was 81.5%in the experimental group and 73.8%in the control group,the difference was not statistically significant（x²=1.110、P=0.292）.In terms of laboratory indicators,the white blood cell count in the experimental group after treatment was（6.78±2.23）×10⁹/L,control group（7.81±2.86）×10⁹/L,the difference was statistically significant（t value-2.282,P=0.024）.Procalcitonin group after treatment（0.154±0.195）ng/ml,control group（0.239±235）ng/ml,the difference was statistically significant（t value-2.240,P=0.027）.The change of PCO₂in patients withⅡtype respiratory failure before and after treatment in the experimental group（20.62±6.40）mm Hg was better than that in the control group（13.93±9.26）mm Hg,the difference was statistically significant（t value 2.570,P=0.015）.After treatment,FEV1/pred was（63.59±13.56）%in the experimental group and（54.43±12.57）%in the control group.The difference was statistically significant（t value 3.998,P<0.001）.In the experimental group,FEV1/FVC was（55.16±8.76）%after treatment,control group（51.26±10.24）%,the difference was statistically significant（t value 2.335,P=0.021）.The duration of antibiotic use and average length of hospital stay in the experimental group[（6.75±1.94）,（9.78±2.40）]d were lower than those in the control group[（8.85±1.99）,（11.37±2.56）]d.The difference was statistically significant（t value-6.081,-3.679,all P<0.001）.There was no significant difference in acute exacerbation during the follow-up period of 6 months（x²=0.074、P=0.785）.Conclusion:Moxifloxacin can be used in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease without risk factors of Pseudomonas aeruginosa infection,with better pulmonary function improvement,shorter use time of antibiotics and hospital stay,The mergerⅡtype of respiratory failure have more advantages in the subgroups,and good tolerability.