莫西沙星对社区获得性肺炎治疗作用的研究进展

摘要/Abstract

摘要： 社区获得性肺炎是指在医院外罹患的感染性肺实质炎症,是威胁人类健康的常见感染性疾病之一。莫西沙星作为第四代氟喹诺酮类药物,常用于社区获得性肺炎的治疗。其抗菌活性强,人体耐受性好,不良反应发生率低,具有广泛的临床应用前景。本文对莫西沙星的药动学、药效学和用药安全性问题进行综述,以为莫西沙星的合理应用提供参考。

关键词: 莫西沙星, 社区获得性肺炎, 药动学, 药效学, 安全性

Abstract: Community-acquired pneumonia(CAP), the inflammation of lung parenchyma, is one of the common infectious disease threaten human health. Moxifloxacin is the fourth-generation fluoroquinolone, usually used to treat CAP. Moxifloxacin holds extensive promise for clinical application because of the high antibacterial activity, low incidences of adverse effect and well tolerated. This article summarizes pharmacokinetics, pharmacodynamics and safety of Moxifloxacin to provide reference for its reasonable application.

Key words: moxifloxacin, community-acquired pneumonia, pharmacokinetics, pharmacodynamics, safety

中图分类号:

R969.1

朱文静, 崔卫华, 王少华, 张媛媛, 高纪军. 莫西沙星对社区获得性肺炎治疗作用的研究进展[J]. 中国临床药理学与治疗学, 2015, 20(5): 597-600.

ZHU Wen-jing, CUI Wei-hua, WANG Shao-hua, ZHANG Yuan-yuan, GAO Ji-jun. Development of moxifloxacin in treating community-acquired pneumonia[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2015, 20(5): 597-600.

参考文献

[1] Watkins RR, Lemonovich TL. Diagnosis and management of community-acquired pneumonia in adults[J]. Am Fam Physician,2011,183(11):1299-1306.
[2] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南( 2007年修订版)[J].中华结核和呼吸杂志,2007,30(1):8-17.
[3] 徐作军.《成人肺炎支原体肺炎诊治专家共识》浅析[J].中国实用内科杂志,2010,30(12):1146-1147.
[4] 王秀香,杨敬平,卜宝英. 老年COPD并社区获得性肺炎常见病原菌及耐药性分析[J].临床肺科杂志,2008,13(4):426-427.
[5] 陈利云,奚峰,周伟菊,等.成人社区获得性肺炎病原菌分布及其耐药性分析[J].世界临床药物, 2009,30(3):172-181.
[6] Liu YN, Chen MJ, Zhao TM,et al. A multicentre study on the pathogenic agents in 665 adult patients with community-acquired pneumonia in cities of China[J]. Zhong hua Jie He He Hu Xi Za Zhi,2006,29(1):3-8.
[7] 姚苑梅,徐玉红,李东,等. 盐酸莫西沙星片在健康人体的药动学研究[J].中国药师,2010,13(6):793-795.
[8] 徐玉红,李玉珍,李东,等.盐酸莫西沙星片的人体药动学研究[J].中国药房,2010,21(10):898-900.
[9] Miravitlles M. Moxifloxacin in respiratory tract infections[J]. Expert Opin Pharmacother, 2005,6(2):283-293.
[10]Kees MG, Weber S, Kees F, et al. Pharmacokinetics of moxifloxacin in plasma and tissue of morbidly obese patients[J]. Antimicrob Chemother, 2011, 66 (10): 2330-2335.
[11]赖书华. 莫西沙星的药理特性及最新应用进展[J].中国医院用药评价与分析,2010,10(8):682-683.
[12]奚峰,陈利云,周伟菊,等.非典型致病菌在社区获得性肺炎中的分布及其临床意义[J]. 上海医学,2004,27(12):895-897.
[13]Akaike H, Miyashita N, Kubo M, et al. In Vitro Activities of 11 Antimicrobial Agents against Macrolide-Resistant Mycoplasma pneumoniae Isolates from Pediatric Patients: Results from a Multicenter Surveillance Study[J]. Jpn J Infect Dis,2012,65(6):535-538.
[14]Yu LL, Hu BJ, Huang SL, et al. Activity of macrolides and fluoroquinolones against intracellular Legionella pneumophila[J]. Zhong hua Jie He He Hu Xi Za Zhi, 2011,34(6):409-412.
[15]Adam HJ, Laing NM, King　CR,et al. In vitro activity of nemonoxacin, a novel nonfluorinated Quinolone, against 2,440 clinical isolates[J]. Antimicrob Agents Chemother, 2009,53(11): 4915-4920.
[16]Yang Q, Xu Y, Chen M,et al. In vitro activity of cefditoren and other comparators against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis causing community-acquired respiratory tract infections in China[J].Expert Rev Anti Infect Ther,2010,8(11):1259-1271.
[17]Kiffer CR, Pignatari AC. Pharmacodynamic evaluation of commonly prescribed oral antibiotics against respiratory bacterial pathogens[J]. BMC Infect Dis, 2011,11(1):286-294.
[18]Deryke CA, Du X, Nicolau DP. Evaluation of bacterial kills when modelling the bronchopulmonary pharmacokinetic profile of moxifloxacin and levofloxacin against parC-containing isolates of Streptococcus pneumoniae[J]. J Antimicrob Chemother, 2006,58 (3): 601-609.
[19]李燕玉,裴斐.耐药突变选择窗与抗感染药物防突变浓度[J]. 中国临床药理学与治疗学, 2004 ,9 (1) :1-7.
[20]Yoshida K, Okimoto N, Kishimoto M,et al. Efficacy and safety of moxifloxacin for community-acquired bacterial pneumonia based on pharmacokinetic analysis[J]. J Infect Chemother,2011,17(5):678-685.
[21]温学群,魏越浩,黄少华.莫西沙星对老年社区获得性肺炎抗感染治疗的疗效观察[J].当代医学,2011,17(16):138-139.
[22]李芝兰,郭胜利,范永红.莫西沙星与哌拉西林舒巴坦钠治疗社区获得性肺炎的比较研究[J]. 实用预防医学,2012,19(2):237-238.
[23]Wispelwey B, Schafer KR. Fluoroquinolones in the management of community-acquired pneumonia in primary care[J]. Expert Rev Anti Infect Ther, 2010,8(11):1259-1271.
[24]Lloyd A, Holman A, Evers T.A cost-minimisation analysis comparing moxifloxacin with levofloxacin plus ceftriaxone for the treatment of patients with community-acquired pneumonia in Germany: results from the MOTIV trial[J]. Curr Med Res Opin, 2008,24(5): 1279-1284.
[25]Chen R, Ma W, Yu X, et al. Intravenous moxifloxacin in routine hospital treatment of respiratory tract infections in China: results of a multicenter, noninterventional study[J].Int J Gen Med,2011,4: 317-323.
[26]Veyssier P, Voirot P, Begaud B,et al. Cardiac tolerance of moxifloxacin: Clinical experience from a large observational French study in usual medicalpractice[J]. Med Mal Infect, 2006,36(10):505-512.
[27]Haverkamp W, Kruesmann F, Fritsch A, et al. Update on the cardiac safety of moxifloxacin[J]. Curr Drug Saf, 2012,7(2): 149-163.
[28]Paterson JM, Mamdani MM, Manno M, et al. Fluoroquinolone therapy and idiosyncratic acute liver injury: a population-based study[J]. CMAJ,2012,184(14): 1565-1570.