Chen Gui-fang, Fang Yin-huai, Guo De-xing, Feng Xiao-wei, Xiang Wei, Ruan He-qiu
Department of Pediatrics, Hainan Provincial People's Hospital, Haikou 570311, China.
Zhonghua Er Ke Za Zhi. 2004 Jan;42(1):23-5.
To study the therapeutic effects of azithromycin in treatment of congenital toxoplasmosis in children.
Definite diagnosis of congenital toxoplasmosis was made on the basis of clinical manifestation combined with one or more positive results of the following laboratory tests and excluded other congenital infectious diseases: toxoplasma DNA (TOX-DNA), circulating toxoplasma antigen (TOX-CAG), and toxoplasma IgM antibody (TOX-IgM). All the patients were given oral azithromycin 10 mg/(kg.d) for 6 days followed by 8 days without medication (one course of treatment), and the regimen was persisted for 2 months and then another 2-month treatment was given at a 1-month interval. The authors continued to provide further treatment according to the state of the illness at one month interval. The patients received 2 to 8 (average 5) courses of treatment. The patients were followed-up for 2.5 to 5 (average 4) years.
The treatment was effective in all the patients and the patient's condition was improved. The authors repeated in 12 cases the four tests for toxoplasma (TOX-DNA, TOX-CAG, TOX-IgM, and TOX-IgG) 9 months to one and a half years after treatment. In 10 cases all these tests showed negative results, in 2 cases TOX-IgG was positive and in the other 4 cases symptoms disappeared.
The results of the study showed that oral azithromycin had significant therapeutic effects with little side effect and was well tolerated. Azithromycin may become an alternative therapy in treatment of congenital Toxoplasma gondii infection in children.
研究阿奇霉素治疗儿童先天性弓形虫病的疗效。
根据临床表现并结合以下一项或多项实验室检查阳性结果确诊先天性弓形虫病,并排除其他先天性感染性疾病:弓形虫DNA(TOX-DNA)、循环弓形虫抗原(TOX-CAG)和弓形虫IgM抗体(TOX-IgM)。所有患者口服阿奇霉素10mg/(kg·d),连用6天,随后停药8天(一个疗程),该方案持续2个月,然后间隔1个月再进行2个月的治疗。作者根据病情每隔1个月继续给予进一步治疗。患者接受2至8个疗程(平均5个疗程)的治疗。对患者进行2.5至5年(平均4年)的随访。
所有患者治疗均有效,病情均有改善。作者在治疗9个月至1年半后,对12例患者重复进行了四项弓形虫检测(TOX-DNA、TOX-CAG、TOX-IgM和TOX-IgG)。10例患者所有检测结果均为阴性,2例患者TOX-IgG阳性,另外4例患者症状消失。
研究结果表明,口服阿奇霉素疗效显著,副作用小,耐受性良好。阿奇霉素可能成为治疗儿童先天性弓形虫感染的替代疗法。