Margileth A M
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville.
Pediatr Infect Dis J. 1992 Jun;11(6):474-8.
During 24 months in an uncontrolled, retrospective study of 268 patients with cat-scratch disease (CSD), 202 were treated with 18 different antimicrobial agents. Criteria for antibiotic effectiveness were established. One or two antibiotics were taken separately for at least 3 to 5 days by 202 patients with CSD. Outcome was determined by follow-up examinations and telephone. Effectiveness of antibiotic therapy was based upon 3 or more days of therapy and clinical improvement of the patient with absence of and/or a decrease in malaise, fatigue, fever, headache, anorexia, lymphadenopathy and, in 90 patients, a declining or normal sedimentation rate. Of 18 different antimicrobials prescribed, 14 commonly used antibiotics were judged to be of little or no value in treatment of CSD. Four antimicrobials were efficacious. Efficacy of the three oral drugs in decreasing order was: rifampin 87%, ciprofloxacin 84%, trimethoprim-sulfamethoxazole 58%. Gentamicin sulfate intramuscular was 73% effective. Antibiotic therapy can be considered for patients with severe cat scratch disease. Conservative, symptomatic treatment is recommended for the majority of patients with mild or moderate CSD.
在一项针对268例猫抓病（CSD）患者的非对照回顾性研究中，为期24个月，202例患者接受了18种不同的抗菌药物治疗。制定了抗生素疗效标准。202例CSD患者分别服用一种或两种抗生素至少3至5天。通过随访检查和电话确定结果。抗生素治疗的有效性基于至少3天的治疗以及患者临床症状的改善，包括不适、疲劳、发热、头痛、厌食、淋巴结病消失和/或减轻，并且在90例患者中，血沉率下降或恢复正常。在所开的18种不同抗菌药物中，14种常用抗生素被判定对CSD治疗几乎没有价值或毫无价值。四种抗菌药物有效。三种口服药物的疗效从高到低依次为：利福平87%，环丙沙星84%，甲氧苄啶 - 磺胺甲恶唑58%。硫酸庆大霉素肌肉注射有效率为73%。对于重症猫抓病患者可考虑使用抗生素治疗。对于大多数轻度或中度CSD患者，建议采取保守的对症治疗。
