Hoepelman I M, Rozenberg-Arska M, Verhoef J
Department of Internal Medicine, University Hospital, Utrecht, The Netherlands.
Lancet. 1988 Jun 11;1(8598):1305-9. doi: 10.1016/s0140-6736(88)92121-6.
To compare the efficacy of once daily monotherapy with that of standard combination antibiotic therapy for the initial management of patients suspected of serious bacterial infections, 105 patients were randomised to treatment with ceftriaxone alone (53 patients) or to a combination of cefuroxime and gentamicin (52 patients). There was no difference between the groups in proportions responding to therapy or proportions dying from infection, except when non-evaluable patients were excluded from the group with definite bacterial infection, in which case response was better among those treated with ceftriaxone. The groups did not differ in number of side-effects, but therapy had to be discontinued because of treatment failure, an adverse effect, or death in 1 of 53 patients given ceftriaxone and in 11 of 34 given the combination. Use of ceftriaxone was 107.36 pounds ($182.51) cheaper per patient, and saved 40 minutes of nursing and drug administration time per patient per day. Thus 2 g ceftriaxone given once a day is at least as effective and costs less in time and money than gentamicin plus cefuroxime for the initial treatment of patients with serious systemic bacterial infections.
为比较每日一次单药治疗与标准联合抗生素治疗对疑似严重细菌感染患者初始治疗的疗效，105例患者被随机分为两组，一组单独使用头孢曲松治疗（53例患者），另一组使用头孢呋辛和庆大霉素联合治疗（52例患者）。两组在治疗反应率或感染死亡率方面无差异，但在明确细菌感染组中排除不可评估的患者后，头孢曲松治疗组的反应更好。两组在副作用数量上无差异，但在使用头孢曲松治疗的53例患者中有1例、使用联合治疗的34例患者中有11例因治疗失败、不良反应或死亡而不得不停止治疗。使用头孢曲松每位患者可节省107.36英镑（182.51美元），且每位患者每天可节省40分钟的护理和给药时间。因此，对于严重全身性细菌感染患者的初始治疗，每天给予2g头孢曲松至少与庆大霉素加头孢呋辛一样有效，且在时间和金钱方面成本更低。
