Uwaydah A K, al Soub H, Matar I
Department of Internal Medicine, Hamad Medical Corporation, Doha-Qatar, Arabian Gulf.
J Antimicrob Chemother. 1992 Nov;30(5):707-11. doi: 10.1093/jac/30.5.707.
Sixty-two patients with blood culture-proven typhoid fever were randomly assigned to receive either 500 or 750 mg of ciprofloxacin orally, twice daily for 7 days or for two days following defervescence, whichever was greater. Thirty-four and 28 patients received 500 mg and 750 mg respectively. Strains of Salmonella typhi resistant to ampicillin, chloramphenicol and co-trimoxazole were isolated from the blood of 27 patients (43.5%). No resistance to ciprofloxacin was encountered. Both regimens were equally effective; fever subsided in mean times of 4.9 +/- 1.7 days in the 500 mg group and 5.2 +/- 2.2 days in the 750 mg group (P = 0.54). All patients were cured, although one patient in the 750 mg group experienced a presumed relapse two months following completion of therapy. Ciprofloxacin administered for 7-10 days was adequate treatment for 57 of the 62 patients (92%); only five patients required therapy for more than 10 days. Patients with pretreatment symptoms of > or = 10 days duration defervesced in a mean of 5.7 +/- 2.3 days compared with 4.5 +/- 1.3 days (P = 0.01) for those with symptoms of shorter duration. We conclude that 500 mg of ciprofloxacin taken orally twice daily is adequate treatment for typhoid fever.
62例血培养确诊为伤寒热的患者被随机分配，分别口服500毫克或750毫克环丙沙星，每日两次，疗程7天，或在退热后持续用药2天，以时间长者为准。分别有34例和28例患者接受500毫克和750毫克剂量治疗。从27例患者（43.5%）的血液中分离出对氨苄西林、氯霉素和复方新诺明耐药的伤寒沙门氏菌菌株。未发现对环丙沙星耐药的情况。两种治疗方案效果相同；500毫克组发热消退的平均时间为4.9±1.7天，750毫克组为5.2±2.2天（P = 0.54）。所有患者均治愈，尽管750毫克组有1例患者在完成治疗两个月后出现疑似复发。62例患者中有57例（92%）接受7 - 10天的环丙沙星治疗已足够；只有5例患者需要治疗超过10天。治疗前症状持续≥10天的患者发热消退的平均时间为5.7±2.3天，而症状持续时间较短的患者为4.5±1.3天（P = 0.01）。我们得出结论，每日两次口服500毫克环丙沙星是治疗伤寒热的足够剂量。
