Rodríguez W J, Khan W N, Puig J, Feris J, Harmon S, Gold B G, Ahmad S
Rev Infect Dis. 1986 Nov-Dec;8 Suppl 5:S620-9. doi: 10.1093/clinids/8.supplement_5.s620.
Eighty-one patients ages one month to 14 years with meningitis were randomized to receive either sulbactam (50 mg/kg per day) and ampicillin (400 mg/kg per day; 41 patients) or chloramphenicol and ampicillin (40 patients). The groups were comparable in terms of sex and degree of illness; however, more patients treated with chloramphenicol/ampicillin than patients treated with sulbactam/ampicillin were younger than 12 months of age (78% vs. 56%). Pathogens were isolated from the cerebrospinal fluid (CSF) of 65 (80%) of the 81 patients. In the sulbactam/ampicillin group, there were 18 Haemophilus influenzae isolates (one resistant to ampicillin), five Streptococcus pneumoniae, five Neisseria meningitidis, one Klebsiella pneumoniae, one Pseudomonas aeruginosa, and one Listeria. In the chloramphenicol/ampicillin group, there were 19 H. influenzae isolates, 10 S. pneumoniae, three N. meningitidis, one Haemophilus parainfluenzae, and one Citrobacter. Of 63 patients with assessable CSF pathogens, one (3%) of 29 treated with sulbactam/ampicillin died (S. pneumoniae) and six (18%) of 34 treated with chloramphenicol/ampicillin died (two, H. influenzae; three, S. pneumoniae; and one, Citrobacter). Twelve percent in the sulbactam/ampicillin group and 18% in the chloramphenicol/ampicillin group had neurologic sequelae. No clinically significant reactions or toxicities were noted. Sulbactam/ampicillin was as effective as chloramphenicol/ampicillin in the treatment of meningitis.
81例年龄在1个月至14岁的脑膜炎患者被随机分为两组，分别接受舒巴坦（每日50mg/kg）和氨苄西林（每日400mg/kg；41例患者）治疗，或氯霉素和氨苄西林（40例患者）治疗。两组在性别和疾病程度方面具有可比性；然而，接受氯霉素/氨苄西林治疗的患者中年龄小于12个月的比接受舒巴坦/氨苄西林治疗的患者更多（78%对56%）。81例患者中有65例（80%）的脑脊液（CSF）中分离出病原体。在舒巴坦/氨苄西林组，分离出18株流感嗜血杆菌（1株对氨苄西林耐药）、5株肺炎链球菌、5株脑膜炎奈瑟菌、1株肺炎克雷伯菌、1株铜绿假单胞菌和1株李斯特菌。在氯霉素/氨苄西林组，分离出19株流感嗜血杆菌、10株肺炎链球菌、3株脑膜炎奈瑟菌、1株副流感嗜血杆菌和1株柠檬酸杆菌。在63例可评估脑脊液病原体的患者中，接受舒巴坦/氨苄西林治疗的29例中有1例（3%）死亡（肺炎链球菌），接受氯霉素/氨苄西林治疗的34例中有6例（18%）死亡（2例流感嗜血杆菌；3例肺炎链球菌；1例柠檬酸杆菌）。舒巴坦/氨苄西林组有12%的患者出现神经后遗症，氯霉素/氨苄西林组有18%的患者出现神经后遗症。未观察到具有临床意义的反应或毒性。舒巴坦/氨苄西林在治疗脑膜炎方面与氯霉素/氨苄西林同样有效。
