Gray G C, Witucki P J, Gould M T, Bell S J, Hiliopoulos K M, McKeehan J A, Fuller J M, Barrozo C P, Hudspeth M K, Smith T C, Ledbetter E K, Wallace M R
Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, CA 92186-5122, USA.
Clin Infect Dis. 2001 Oct 1;33(7):983-9. doi: 10.1086/322626. Epub 2001 Sep 5.
Military Special Forces trainees undergo intense psychological and physical stressors that often lead to respiratory infection. During 1998-2000, 477 Navy Special Forces trainees were enrolled in a double-blind trial of oral azithromycin (1 g given weekly) plus a placebo injection, compared with benzathine penicillin G (1.2 million U) plus azithromycin placebo tablets. Among the 464 subjects with complete data, 44 developed acute respiratory infection (20 with pneumonia) during the 2 weeks of most intense training; of these subjects, 12 (27.3%) had evidence of Chlamydia pneumoniae infection and 7 (15.9%) had evidence of Mycoplasma pneumoniae infection. Trainees who received azithromycin were less likely than were trainees who received benzathine penicillin G to develop acute respiratory infection (risk ratio, 0.50; 95% confidence interval [CI], 0.28-0.92) and less likely at the end of training to report episodes of breathing difficulty (odds ratio [OR], 0.59; 95% CI, 0.34-1.01) or sore throat (OR, 0.66; 95% CI, 0.41-1.05). Compared with benzathine penicillin G prophylaxis, weekly oral azithromycin was superior in preventing respiratory infection in this population at transient high risk.
军事特种部队学员会经历强烈的心理和身体压力源，这常常导致呼吸道感染。在1998 - 2000年期间，477名海军特种部队学员参与了一项双盲试验，试验内容为口服阿奇霉素（每周1克）加安慰剂注射，与苄星青霉素G（120万单位）加阿奇霉素安慰剂片剂进行对比。在464名有完整数据的受试者中，44人在最紧张训练的2周内发生了急性呼吸道感染（20人患肺炎）；在这些受试者中，12人（27.3%）有肺炎衣原体感染证据，7人（15.9%）有肺炎支原体感染证据。接受阿奇霉素治疗的学员比接受苄星青霉素G治疗的学员发生急性呼吸道感染的可能性更小（风险比为0.50；95%置信区间[CI]为0.28 - 0.92），且在训练结束时报告呼吸困难发作（比值比[OR]为0.59；95%CI为0.34 - 1.01）或喉咙痛（OR为0.66；95%CI为0.41 - 1.05）的可能性也更小。与苄星青霉素G预防措施相比，每周口服阿奇霉素在预防这一短暂高风险人群的呼吸道感染方面更具优势。
