摘要：
Objective To evaluate the efficacy and safety of azithromycin in the treatment of pelvic inflammatory disease (PID)that requires initial intravenous injection therapy.Methods Sequential therapy was performed in 300 patients with acute PID (in early stage,intravenous injection azithromycin (500 mg once a day)for 1~2 days followed by oral azithromycin (250 mg once a day,a total of 7 days treatment).At the end of treatment (EOT),the 1 5th and 29th day,clinical effective rate and bacterial eradication rate were evaluated.Results The most commonly detected baseline causative pathogens were Chlamydia trachomatis (60 strains), Prevotella bivia (50 strains),Streptococcus agalactiae (35 strains)onorrhoeae and Peptostreptococcus anaerobius (respective 30 strains).The clinical effective rate and bacterial eradication rate analysis were carried out.At the EOT,C.trachomatis were 100%(60/60)and 72.7%(40/55),P .copri were 90%(45/50)and 80.0%(40/50),Streptococcus agalactiae were 85.7%(30/35)and 57.1%(20/35),Gonococcus were 100%(30/30)and 33.3%(10/30),and Peptostreptococcus anaerobius were both 83.3%(25/30).The above descriptions of all kinds of bacteria had no significant change for clinical effective rate and the bacterial eradication rate was increased in late stage.Common treatment-related adverse events were diarrhea,injection site pain,and nausea.All ad-verse events were mild or moderate in severity.Conclusion Azithromycin intravenous-to-oral sequential therapy demonstrated ex-cellent clinical and bacteriological effects for PID caused by various etiologic agents including quinolone-resistant strains and strains with low susceptibility to azithromycin at in vitro testing.The therapy was well tolerated in the treatment of PID in clinic.%目的探讨阿奇霉素序贯疗法治疗盆腔炎性疾病的疗效和安全性。方法300例急性盆腔炎性疾病患者进行序贯疗法(前期静脉注射阿奇霉素500 mg,每日1次,1~2 d；后改为口服阿奇霉素250 mg,每日1次,共治疗7 d)。治疗结束当日、治疗后第15天及第29天评估临床有效率和细菌根除率。结果病例样本最常见的病原体为：沙眼衣原体(60株)、二路普氏菌(50株)、无乳链球菌(35株)、淋球菌(30株)和厌氧消化链球菌(30株)。临床进行临床有效率和细菌根除率分析,治疗结束当日,沙眼衣原体感染者分别为100%(60/60)和72.7%(40/55),二路普氏菌感染者分别为90%(45/50)和80%(40/50),无乳链球菌感染者分别为85.7%(30/35)和57.1%(20/35),淋球菌感染者分别为100%(30/30)和33.3%(10/30),厌氧消化链球菌感染者分别为83.3%(25/30)和83.3%(25/30)。临床有效率,第15天和第29天各菌种治疗有效率均无显著变化。细菌根除率和后期根除率均有所提高。相关的常见不良反应是腹泻、注射部位疼痛和恶心,均为轻度或中度。结论阿奇霉素序贯疗法能够有效治疗盆腔多种病原微生物,包括喹诺酮耐药菌引起的盆腔炎,且患者耐受性良好。
