目的 评价高剂量左氧氟沙星序贯给药治疗老年呼吸道感染的疗效与安全性.方法 采用前瞻性随机开放试验设计方法,对60例老年急性呼吸道感染患者,采用高剂量左氧氟沙星(可乐必妥500 mg)静脉滴注,1次/d,3～5 d,继以可乐必妥500 mg口服,1次/d,5～10 d,总疗程8～15 d.观察临床疗效和不良反应情况.结果 临床总有效率为93.3%.其中临床症状和体征改善有效率为100%,胸片阴影改善好转率为90%,降低白细胞计数及中性粒细胞有效率为100%,细菌清除率100%.不良反应以胃肠道反应为多见,实验室检查异常发生率均系轻度改变,并呈一过性,无需处理.结论 本研究结果显示,高剂量左氧氟沙星序贯给药治疗老年呼吸道感染疗效良好,安全、方便,不良反应发生率低,患者依从性好.%Objective To evaluate the clinical therapeutic effect and safety of sequential intravenous-to-oral (Ⅳ/PO) high dose( 500 mg)levofloxacin therapy on the treatment of elderly patients with respiratory infections.Methods A prospective,randomized, open clinical trial was conducted.60 elderly patients with acute respiratory infection,uses high dose( 500 mg)levofloxacin(cravit) by intravenous infusion once-daily for 3 ～ 5 days, then took orally oncedaily levofloxacin 500 mg/d for 5 ～ 10 days,The duration was 8 ～ 15 days.The clinical curative effect and the adverse effects situation analysis were made after treatment.Results The clinical total effective rate was 93.3％ ,and the clinical symptoms and signs improvement effective rate was 100％ ,the chest x-ray shadow improvement rate was 90％ ,reducing rate of the white blood cell counts and neutral granular cells was 100％ ,bacteria clearance rate was 100％.The incidence of treatment-related adverse events was lower, and the main adverse drug reactions were the gastro-intestinal tract response, the mild laboratory parameters abnormal changes from baseline were found, and it was transient, no treatment was needed.Conclusion The study showed that the sequential IV/PO high dose levofloxacin therapy in treating elderly patients with respiratory infections was effective, convenient and safe with less adverse drug reactions, and patients' compliance were good.
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