Liang R H, Yung R W, Chan T K, Chau P Y, Lam W K, So S Y, Todd D
University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam.
Antimicrob Agents Chemother. 1990 Feb;34(2):215-8. doi: 10.1128/AAC.34.2.215.
The efficacy of ofloxacin in preventing infection in neutropenic patients following cytotoxic chemotherapy was evaluated and was compared with that of co-trimoxazole. A total of 102 patients with hematological malignancies were randomly selected to receive either co-trimoxazole or ofloxacin. All patients were monitored for compliance, occurrence of infection, and drug-related side effects. A surveillance culture of a rectal swab was performed regularly. A total of 25 of the 52 patients (48%) who received co-trimoxazole and 11 of the 50 patients (22%) who received ofloxacin developed fever during the study period (P less than 0.025). Gram-negative bacteremia occurred in nine patients in the co-trimoxazole group (17%) but in only one patient (2%) in the ofloxacin group (P less than 0.05). No patient in either group had documented gram-positive bacterial or Pneumocystis carinii infection. Poor performance status was the only identifiable factor associated with an increased incidence of bacteremia. The surveillance study showed that significantly fewer bacterial strains were resistant to ofloxacin than to co-trimoxazole and that acquisition of resistance to co-trimoxazole was more commonly observed than was acquisition of resistance to ofloxacin. Significantly more patients had skin rashes following co-trimoxazole than ofloxacin treatment (P less than 0.05). Ofloxacin was superior to co-trimoxazole in preventing infection in this population of neutropenic patients.
对氧氟沙星在预防细胞毒性化疗后中性粒细胞减少患者感染方面的疗效进行了评估，并与复方新诺明进行了比较。总共随机选择了102例血液系统恶性肿瘤患者，分别接受复方新诺明或氧氟沙星治疗。对所有患者进行依从性、感染发生情况及药物相关副作用监测。定期进行直肠拭子的监测培养。在研究期间，接受复方新诺明治疗的52例患者中有25例（48%）出现发热，接受氧氟沙星治疗的50例患者中有11例（22%）出现发热（P小于0.025）。复方新诺明组有9例患者（17%）发生革兰阴性菌血症，而氧氟沙星组仅有1例患者（2%）发生革兰阴性菌血症（P小于0.05）。两组均无患者记录到革兰阳性菌或卡氏肺孢子虫感染。身体状况差是与菌血症发生率增加相关的唯一可识别因素。监测研究表明，对氧氟沙星耐药的细菌菌株明显少于对复方新诺明耐药的细菌菌株，而且与获得对氧氟沙星的耐药性相比，获得对复方新诺明的耐药性更为常见。接受复方新诺明治疗后出现皮疹的患者明显多于接受氧氟沙星治疗的患者（P小于0.05）。在预防这群中性粒细胞减少患者感染方面，氧氟沙星优于复方新诺明。
