Meade R H
JAMA. 1978 Jan 23;239(4):324-7.
The increasing number of ampicillin-resistant Haemophilus influenzae recoveries have required a change in the treatment of meningitis due to this organism. Chloramphenicol has been recommended and is an effective though toxic substitute. Streptomycin combined with sulfisoxazole has been as effective as ampicillin in treating H influenzae meningitis. The results of treating 61 children with ampicillin were compared with results of those given streptomycin intramuscularly, in three intrathecal doses with sulfisoxazole intravenously, and by mouth to 50 children. Permanent neurological sequelae, including deafness, mental retardation, and persisting seizures, developed in the six given ampicillin; communic-ting hydrocephalus occurred in one who had been treated with streptomycin and sulfisoxazole. There was no phlebitis, buttocks abscess, or drug eruptions, and treatment was better tolerated in the streptomycin and sulfisoxazole group. This combination is suggested as an effective alternative to ampicillin.
对氨苄西林耐药的流感嗜血杆菌感染病例日益增多，因此需要改变针对该病原体所致脑膜炎的治疗方法。有人推荐使用氯霉素，它虽有毒性，但却是一种有效的替代药物。链霉素与磺胺异恶唑联合使用，在治疗流感嗜血杆菌脑膜炎方面与氨苄西林效果相当。将61例接受氨苄西林治疗的儿童的结果，与50例接受链霉素肌内注射、分三次鞘内给药并静脉及口服磺胺异恶唑治疗的儿童的结果进行了比较。接受氨苄西林治疗的6例患儿出现了永久性神经后遗症，包括耳聋、智力发育迟缓及持续性癫痫发作；接受链霉素和磺胺异恶唑治疗的1例患儿出现了交通性脑积水。未出现静脉炎、臀部脓肿或药疹，链霉素和磺胺异恶唑组对治疗的耐受性更好。建议将这种联合用药作为氨苄西林的一种有效替代方案。
