Objective To evaluate the clinical efficacy and safety of ertapenem as empirical treatment of severe community-acquired pneumonia in elderly patients. Methods A total of 84 elderly patients with severe community-acquired pneumonia were randomized to receive ertapenem 1 g once daily by intravenous infusion plus azithromycin 0. 5 g/d for 6 to 9 days (experiment group, n = 42); or ceftizoxime 3. 0-4. 5 g by IV infusion over 12 h plus azithromycin 0. 5 g/d for 10 to 14 days (control group, n = 42). The clinical efficacy and adverse drug reactions were documented before and after treatment. Results The overall efficacy rate in the experiment group was significantly higher than that in the control group (85. 4% vs 65. 3% ; P<0. 05). The fatality rate was similar between the two groups (7. 32% vs 19. 0% , P>0. 05). The experiment group showed faster onset of efficacy, shorter hospital stay (days) and lower cost of hospitalization than the control group. The adverse drug reactions were generally few and mild in both groups. Conclusions This analysis indicates that ertapenem plus azithromycin is effective and safe for treating severe community-acquired pneumonia in elderly patients. Tt can be used as appropriate initial empirical antibiotic treatment.%目的 观察厄他培南初始经验性治疗老年重症社区获得性肺炎(CAP)的疗效及不良反应.方法 将2008年1月2011年4月上海市闸北区中心医院住院老年重症社区获得性肺炎患者随机分厄他培南组和头孢唑肟组.分别采用厄他培南联合阿奇霉素以及头孢唑肟钠联合阿奇霉素的经验性治疗.观察两组的疗效和不良反应.结果 共83例患者人选,厄他培南组41例,头孢唑肟组42例.临床疗效比较:前者有效率85.4％,后者有效率65.3％,差异有统计学意义.且厄他培南组治疗显效快,总住院天数短,住院费用减少.两组病死率差异无统计学意义,不良反应均少见而轻微.结论 厄他培南联合阿奇霉素治疗老年重症CAP疗效确切,不良反应少,是治疗老年重症CAP恰当的初始经验性治疗.
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