Gasem M Hussein, Keuter Monique, Dolmans Wil M V, Van Der Ven-Jongekrijg Johanna, Djokomoeljanto Robert, Van Der Meer Jos W M
Department of Medicine, Dr. Kariadi Hospital, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Antimicrob Agents Chemother. 2003 May;47(5):1727-31. doi: 10.1128/AAC.47.5.1727-1731.2003.
We performed a randomized controlled trial involving 55 adult patients with enteric fever to compare ciprofloxacin and chloramphenicol. Blood and bone marrow cultures and cytokine profiles during therapy were done to compare the clinical and bacteriological efficacies of these drugs. All patients were randomly assigned to receive chloramphenicol (500 mg four times a day orally) for 14 days or ciprofloxacin (500 mg twice a day orally) for 7 days. In each treatment group, patients were subsequently randomized to have blood and bone marrow cultured after either 3 or 5 days of treatment. Twenty-seven patients received chloramphenicol, and 28 received ciprofloxacin. The two groups were similar in terms of baseline characteristics. No significant differences in clinical cure and time to defervescence were found. All strains isolated were susceptible to both antibiotics. Although ciprofloxacin was more effective in the elimination of Salmonella enterica serovars Typhi and Paratyphi A from bone marrow than chloramphenicol, there was still an impressive persistence of Salmonella in the bone marrow culture (67%). In the ciprofloxacin-treated patients the suppressed cytokine production capacity showed a trend to normalize earlier than in patients treated with chloramphenicol.
我们进行了一项随机对照试验，纳入了55例成人肠热症患者，以比较环丙沙星和氯霉素。在治疗期间进行了血液和骨髓培养以及细胞因子分析，以比较这两种药物的临床和细菌学疗效。所有患者被随机分配接受氯霉素（每日4次，每次500 mg口服）治疗14天或环丙沙星（每日2次，每次500 mg口服）治疗7天。在每个治疗组中，患者随后在治疗3天或5天后被随机分组进行血液和骨髓培养。27例患者接受氯霉素治疗，28例接受环丙沙星治疗。两组在基线特征方面相似。在临床治愈和退热时间方面未发现显著差异。所有分离出的菌株对两种抗生素均敏感。虽然环丙沙星在从骨髓中清除伤寒沙门菌血清型伤寒杆菌和副伤寒甲杆菌方面比氯霉素更有效，但骨髓培养中仍有相当比例（67%）的沙门菌持续存在。在接受环丙沙星治疗的患者中，细胞因子产生能力的抑制比接受氯霉素治疗的患者更早呈现出恢复正常的趋势。
