关键词: 莫西沙星, 头孢曲松, 亚胺培南, 重症社区获得性肺炎, 炎症因子

Abstract: Objective To explore the efficacy of quinolones alone, combined with β-lactam ceftriaxone and carbapenems alone in the treatment of patients with severe community acquired pneumonia. Methods A total of 105 severe community-acquired pneumonia cases in the department of intensive care medicine from June 2016 to August 2020 were enrolled in our hospital. They were divided into three groups according to their use of antibiotics. The first group were treated with moxifloxacin (quinolone drug), the second group patients were treated with ceftriaxone combined with moxifloxacin (β-lactam antibiotic combined with quinolone), and the third group patients were treated with imipenem (carbapenem antibiotic) as a single agent. We compared the total effective rate of the three groups of treatment, the use time of antibacterial drugs, the improvement time of clinical symptoms (cough, sputum, fever and pulmonary rale), mechanical ventilation time, the length of stay in ICU, and the changes in the levels of inflammation indicators (WBC, CRP and PCT). Results Among 105 patients, there was no significant difference in total effective rate between the first group and the second group(χ²=8.274,P= 0.116) and between the second group and the third group (χ²=0.311,P=0.856), but statistically significant difference between the first group and the third group (χ²=10.679,P=0.005). In terms of clinical indicators, patients of three groups were all improved. There was statistically significant difference in all clinical indicators between the first group and the second group（P<0.05）; Except for the length of stay in the ICU, the difference was statistically significant in other indicators between the first group and the third group（P<0.05）, and only the length of stay in ICU was statistically different between the second group the third group（P<0.05）. The inflammatory factors of the three groups were reduced after treatment（P<0.05）. The reduction of blood WBC and PCT level showed statistically difference between the first group and the second group（P<0.05）; The reduction of the blood WBC and CRP in the first group compared with the third group; Only the reduction of blood PCT level were statistically significant in the second group compared with the third group (P<0.05). Conclusion In the treatment of severe community-acquired pneumonia, compared with moxifloxacin alone, moxifloxacin combined with ceftriaxone, and imipenem alone have better effect.

Key words: Moxifloxacin, Ceftriaxone, Imipenem, Community acquired pneumonia, Inflammatory factors