Abstract: Objective To compare the efficacy and safety of Moxifloxacin and Levofloxacin by sequential administration in the treatment of acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD) in the elderly. Methods A total of 120 elderly patients with severe AECOPD admitted from January 2017 to October 2019 were randomly divided into observation group and control group with 60 cases in each group. In the observation group, Moxifloxacin was given sequentially, while in the control group, Levofloxacin was given sequentially. All subjects were treated continuously for 10 days. The bacteria clearance and the occurrence of side reaction were counted. Before and after treatment, the parameters of lung function, such as forced breath volume in the first second (FEV₁), forced vital capacity (FVC), FEV₁/FVC, arterial oxygen and carbon dioxide partial pressure (PaO₂ and PaCO₂) and arterial oxygenation were measured and compared. Results After treatment, the total effective rate of the observation group was 91. 67% (55/60), which was significantly higher than that of the control group (73. 33%). In the observation group, 38 strains were isolated and 31 strains were eliminated, and the pathogen clearance rate was 81. 58% (31/38), compared with 60. 00%(21/35) in the control group. After treatment, FEV₁, FVC and FEV₁ / FVC in the two groups were significantly higher than those before treatment, especially in the observation group (P<0. 05). The levels of PaO₂ and SaO₂ were significantly increased, and the level of PaCO₂ was significantly decreased in both groups after treatment, and especially in the observation group(P<0. 05). There was no significant difference in the adverse reaction rate between the two groups (8. 33% vs 10. 00%, P>0. 05). Conclusions The sequential therapy of moxexine in the treatment of severe AECOPD in the elderly can improve the pulmonary function, hypoxia and carbon dioxide retention, and the clearance rate of pathogenic bacteria is more significantly than the sequential therapy of Levofloxacin.
   

Key words: Moxifloxacin, Levofloxacin, sequential drug administration, aged, acute exacerbation of severe chronic obstructive pulmonary disease, efficacy