Peterson L R, Quick J N, Jensen B, Homann S, Johnson S, Tenquist J, Shanholtzer C, Petzel R A, Sinn L, Gerding D N
Microbiology Section, Veterans Administration Medical Center, Minneapolis, MN 55417.
Arch Intern Med. 1990 Oct;150(10):2151-5.
We initiated a randomized, single-blinded trial of ciprofloxacin plus rifampin vs sulfamethoxazole and trimethoprim plus rifampin in the therapy for patients who underwent colonization with methicillin-resistant Staphylococcus aureus (MRSA). Patients who were colonized with MRSA received 2 weeks of either regimen. The study was terminated after the enrollment of 21 subjects due to the recognition of ciprofloxacin resistance in 10 of 21 new MRSA isolates during the last 2 months of the study. Five of the 10 patients with ciprofloxacin-resistant MRSA isolates had never received ciprofloxacin. Long-term (6-month) eradication had been achieved in only three of 11 ciprofloxacin plus rifampin and four of 10 sulfamethoxazole and trimethoprim plus rifampin recipients. The use of this new fluoroquinolone for the eradication of MRSA colonization is usually not effective and may risk the development of ciprofloxacin resistance in MRSA within the hospital environment.
我们开展了一项随机、单盲试验，比较环丙沙星联合利福平与磺胺甲恶唑及甲氧苄啶联合利福平治疗耐甲氧西林金黄色葡萄球菌（MRSA）定植患者的疗效。MRSA定植患者接受为期2周的任一治疗方案。在研究的最后2个月，21株新的MRSA分离株中有10株出现环丙沙星耐药，因此在纳入21名受试者后该研究终止。10例分离出对环丙沙星耐药的MRSA菌株的患者中，有5例从未接受过环丙沙星治疗。在接受环丙沙星联合利福平治疗的11例患者中，只有3例实现了长期（6个月）清除；在接受磺胺甲恶唑及甲氧苄啶联合利福平治疗的10例患者中，只有4例实现了长期清除。使用这种新型氟喹诺酮类药物根除MRSA定植通常无效，且可能会增加医院环境中MRSA对环丙沙星产生耐药性的风险。
