Comparative Effectiveness of Fluoroquinolone and Non-fluoroquinolone Antibiotic in Uncomplicated Acute Exacerbations of COPD
Objective:To investigate the clinical effects of fluoroquinolone and non-fluoroquinolone in uncomplicated acute exacerbations of COPD,so as to provide evidence for the direction of clinical antibiotic selection,and improve favorable project.Methods:168 patients with AECOPD in the hospital from January 2018 to December 2020 were chosen,and divided into fluoroquinolone treatment group and non-fluoroquinolone treatment group.In the non-fluoroquinolone treatment group,the therapeutic range of antibiotics was amoxicillin,second or third generation cephalosporins and macrolides.The clinical status,levels of inflammatory cytokines,pulmonary ventilation function,X-ray film improvement rate,length of hospitalization,incidence of adverse reactions and the number of re-admission to hospital within 1 year were compared between the two groups.Results:The improvement time of cough,sputum,asthma and dry and wet rales of both lungs in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant(Z=2.406,2.899,2.489,2.122;P＜0.05).After treatment,PaO2 level in fluoroquinolone treatment group was lower than that in non-fluoroquinolone treatment group,and the difference was statistically significant(t=-2.302,P＜0.05).The improvement rate of lung X-ray film in fluoroquinolone treatment group was lower than that in non-fluoroquinolone treatment group,and the difference was statistically significant(x2=4.660,P＜0.05).The hospitalization stay in fluoroquinolone treatment group was longer than that in non-fluoroquinolone treatment group,and the difference was statistically significant(Z=2.034,P＜0.05).The incidence of adverse reactions in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant(x2＝4.831,P＜0.05).The number of outpatient and inpatient readmissions in fluoroquinolone treatment group was higher than that in non-fluoroquinolone treatment group,and the difference was statistically significant(Z=1.965,2.150;P＜0.05).Conclusion:Fluoroquinolones are inferior to non-fluoroquinolones in the treatment of uncomplicated AECOPD in clinical efficacy,safety and prognosis.
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