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The Retrospectively Analysis of Effect on Three Kinds of Regimens for non-ICU Community Acquired Pneumonia

Author: ZhangRui
Tutor: WangZhenShan
School: Dalian Medical University
Course: Internal Medicine
Keywords: Community-acquired pneumonia Respiratory fluoroquinolones Beta-Lactam antibacterials Macrolides antibacterials
CLC: R563.1
Type: Master's thesis
Year: 2013
Downloads: 14
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Abstract


Objective: We adopt retrospective analysis to know the curative effect of respiratoryfluoroquinolones,beta-lactam antibacterials and beta lactam combined with macrolidesantibacterials on treatment of non-ICU community acquired pneumonia (CAP) inadults.Methods:282cases adult CAP patients in the respiration department of the secondhospital affiliated to Dalian Medical University from January of2009to December2012were collected. According to treatment strategy, all patients were divided intorespiratory fluoroquinolones group (group A), beta-lactam group (group B)andbeta-lactam combined with macrolides group (group C),and also were divided into olderage-group (≥65years old),young and middle-aged group(18~<65years old).Allpatients had an acute onset and conformed to CAP diagnosis and treatment guidelinesmade by the Chinese Medical Association Branch of Breathing, and it was invalid thatantimicrobial drug was cured3days outside hospital, excepting for the followingcrowds: people had tuberculosis, lung cancer, bronchiectasis disease,COPD,obstructivepneumonia,other infection disease and so on, people had risk factors for multiple drugresistance.We collected blood routine,the highest temperature,the time of temperatureback to normal after3days treatment, the case of changed therapeutic schedule and soon,and analysed the datas with SPSS17.0statistical software.Results: among the282cases of adult patients with CAP,165cases were male,117cases were female,average age was (55.0±1.2) year old,126cases were older age-group,156cases were young and middle-aged group.Respiratory fluoroquinolones (group A),beta-lactam antibacterials(group B),beta-lactam antibacterials combined withmacrolides antibacterials (group C) were adopted to treat young and middle-aged groupCAP.The percent of temperature back to normal after3days treatment was significantstatistical difference (χ2=9.754,P=0.008<0.05),there was no significant differencebetween group A and B(χ2=2.5,P=0.082>0.0167), group B and C (χ2=2.974,P=0.063>0.0167),but there was statistically significant difference betweengroup A and C (χ2=9.755,P=0.002<0.0167),respiratory fluoroquinolones was superiorto the beta lactam combined with macrolides antibacterials.There was no statisticaldifference for the percent of cases changed treatment strategy when initial treatment wasfailure(χ2=4.027,P=0.134>0.05).There was no statistical differences for time oftemperature back to normal when the initial treatment wassuccessful(P=0.061>0.05).Older age-group were treated with respiratoryfluoroquinolones and beta-lactam antibacterials.The percent of temperature back tonormal after3days treatment was no statistical difference (χ2=1.309, P=0.176>0.05).The percent of changing scheme showed statistically significant,(χ2=4.080,P=0.033<0.05), respiratory fluoroquinolones was superior to the beta-lactamantibacterials.The time of temperature back to normal was no statistical difference(P=0.624>0.05). Compareing the effect between respiratory fluoroquinolones andbeta-lactam antibacterials,the result showed no statistically difference (P>0.05)by indexabove on.Conclusion:For young and middle-aged CAP,there is no difference in the curativeeffect for three kinds of strategy,and fluoroquinolones has a higher ratio to beta-lactamcombined with macrolides on the temperature back to normal. Fluoroquinolonesefficacy is superior to beta lactam on elderly.

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CLC: > Medicine, health > Internal Medicine > Respiratory system and chest diseases > Pulmonary disease > Pneumonia
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