Objective To compare the systematic and lung pharmacokinetic parameters of moxifloxacin hydrochloride and explore a feasible tool to monitor drug concentration and evaluate therapeutic efficacy of respiratory fluoroquinolones. Methods Ten adult patients with community-acquired pneumonia or acute exacerbation of chronic bronchitis were enrolled.The subjects received a single dose of oral moxifloxacin hydrochloride 400 mg. Serum specimens were sampled at 0，1，2，3，4，8，24 h and sputum specimens were collected 0，1，2，4，8，20，24 h after administration，respectively.The serum and sputum concentrations of moxifloxacin hydrochloride were assayed by means of high-performance liquid chromatography. Standard pharmacokinetic parameters including peak concentrations(Cmax) and area under the concentration-time curve (AUC0-24 h) were assessed. Results Serum C(max) was（5.95±1.35）mg/L at 2 hours and serum AUC0-24 h was (58.72±8.11）mg·h-1·L-1 while sputum Cmax and AUC0-24 h were （16.18±6.47）mg/L at 3 hours and （138.04±78.29）mg·h-1·L-1 respectively，which were significantly higher than those in serum. Conclusion Oral administration of moxifloxacin hydrochloride to patients with respiratory infections results in rapid penetration into lung and maintain a one-fold drug concentration compared to blood concentration within 24 hours.Sputum drug concentration analysis demonstrates a superior pharmacokinetic profile of moxifloxacin in respiratory tract.
ObjectiveTo investigate the clinical efficacy of CoughAssist for cleaning airway secretions in neuromuscular disease patients with respiratory insufficiency. MethodsForty-six cases of neuromuscular disease with respiratory insufficiency were recruited in the study,with Guillain-Barre syndrome in 24 cases,myasthenia gravis in 18 cases,and multiple myositis in 4 patients.Thirty-four patients underwent intubation and mechanical ventilation,and 12 patients underwent tracheotomy.They were randomly divided into group A using CoughAssist and group B using suction tube to clear airway secretions after mechanical vibration.The frequency of suction within 24 hours,oxygenation index,pulmonary static compliance,incidence of lung infections,lung auscultation and chest radiograph were recorded and compared between two groups. ResultsCoughAssist could more effectively clean respiratory secretions with higher oxygenation index and pulmonary static compliance in group A.Lung auscultation and chest radiograph significantly improved,and the incidence of lung infection significantly decreased in group A compared with group B.Furthermore,CoughAssist reduced nursing workload with lower frequency of suction within 24 hours. ConclusionCoughAssist can effectively clean up airway secretions,improve oxygenation,while reducing pulmonary infection and nursing workload for neuromuscular disease patients with respiratory insufficiency,so it is aworthy tool in clincal practice.