Chang Chia-Ming, Lee Hsin-Chun, Lee Nan-Yao, Huang Guan-Cheng, Lee I-Wen, Ko Wen-Chien
Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Pharmacotherapy. 2006 Nov;26(11):1671-4. doi: 10.1592/phco.26.11.1671.
Therapeutic failure of monotherapy with either a third-generation cephalosporin or a fluoroquinolone against nontyphoid salmonellae has been observed in clinical practice. Combination therapy with both agents is recommended in the literature for treating life-threatening infections. However, we know of no published case reports that indicate a therapeutic advantage of this combination therapy for nontyphoid salmonellae infections. We describe a 60-year-old man who had breakthrough bacteremia with vertebral osteomyelitis and paravertebral abscess caused by Salmonella enterica serotype Choleraesuis. This was not controlled with sequential monotherapy but was eventually cured with cefotaxime-ciprofloxacin combination therapy. The Etest showed that the strain was susceptible to cefotaxime and ciprofloxacin, but resistant to nalidixic acid. Cefotaxime and ciprofloxacin in combination may be considered as an option for difficult-to-treat salmonellosis.
在临床实践中，已观察到使用第三代头孢菌素或氟喹诺酮单药治疗非伤寒沙门氏菌存在治疗失败的情况。文献中推荐使用这两种药物联合治疗危及生命的感染。然而，我们尚未知晓有已发表的病例报告表明这种联合疗法对非伤寒沙门氏菌感染具有治疗优势。我们描述了一名60岁男性，他因肠炎沙门氏菌猪霍乱血清型导致椎骨骨髓炎和椎旁脓肿并发突破性菌血症。序贯单药治疗未能控制病情，但最终头孢噻肟 - 环丙沙星联合治疗使其治愈。Etest检测显示该菌株对头孢噻肟和环丙沙星敏感，但对萘啶酸耐药。头孢噻肟和环丙沙星联合使用可被视为治疗难治性沙门氏菌病的一种选择。
