Frenck Robert W, Mansour Adel, Nakhla Isabelle, Sultan Yehia, Putnam Shannon, Wierzba Thomas, Morsy Mosaad, Knirsch Charles
US Naval Medical Research Unit #3, Cairo, Egypt.
Clin Infect Dis. 2004 Apr 1;38(7):951-7. doi: 10.1086/382359. Epub 2004 Mar 12.
We studied 149 children and adolescents 3-17 years of age with clinical typhoid fever who were treated with either oral azithromycin (20 mg/kg per day; maximum dose, 1000 mg/day) or intravenous ceftriaxone (75 mg/day; maximum dose, 2.5 g/day) daily for 5 days. Blood and stool specimens were obtained for culture before the initiation of therapy and were repeated on days 4 and 8 of treatment. Isolation of Salmonella enterica serovar Typhi or S. enterica serovar Paratyphi from the initial culture was required for inclusion in the final analysis. S. Typhi was isolated from 68 patients, 32 of whom were receiving azithromycin. Cure was achieved in 30 (94%) of 32 patients in the azithromycin group and in 35 (97%) of 36 patients in the ceftriaxone group (P=NS). Mean time to clearance of bacteremia was longer in the azithromycin group than in the ceftriaxone group. No patient who received azithromycin had a relapse, compared with 6 patients who received ceftriaxone. A 5-day course of azithromycin was found to be an effective treatment for uncomplicated typhoid fever in children and adolescents.
我们研究了149名3至17岁患有临床伤寒热的儿童和青少年，他们被给予口服阿奇霉素（每日20mg/kg；最大剂量，1000mg/天）或静脉注射头孢曲松（每日75mg；最大剂量，2.5g/天），持续5天。在治疗开始前采集血液和粪便标本进行培养，并在治疗的第4天和第8天重复采集。最终分析纳入标准要求初始培养中分离出伤寒沙门菌血清型伤寒或副伤寒沙门菌血清型。从68名患者中分离出伤寒沙门菌，其中32名接受阿奇霉素治疗。阿奇霉素组32名患者中有30名（94%）治愈，头孢曲松组36名患者中有35名（97%）治愈（P=无显著性差异）。阿奇霉素组菌血症清除的平均时间比头孢曲松组长。接受阿奇霉素治疗的患者无复发，而接受头孢曲松治疗的有6例复发。发现5天疗程的阿奇霉素是治疗儿童和青少年非复杂性伤寒热的有效方法。
