Naamara W, Kunimoto D Y, D'Costa L J, Ndinya-Achola J O, Nsanze H, Ronald A R, Plummer F A
Centre for Microbiology Research, Kenya Medical Research Institute.
Genitourin Med. 1988 Jun;64(3):189-92. doi: 10.1136/sti.64.3.189.
Increasing resistance of Haemophilus ducreyi to antimicrobials necessitates further trials of new antimicrobial agents for treating chancroid. Enoxacin has excellent in vitro activity against H ducreyi, and a randomised clinical trial of three doses of enoxacin 400 mg at intervals of 12 hours compared with a single dose of trimethoprim/sulphametrole (TMP/SMT) 640/3200 mg was therefore conducted. Of 169 men enrolled in the study, 86 received enoxacin and 83 received TMP/SMT. Ulcers were improved or cured in 65/73 men treated with enoxacin and 57/70 men treated with TMP/SMT. This difference was not significant. At 72 hours after treatment, H ducreyi was eradicated from ulcers of 72/77 men treated with enoxacin and of 67/74 of those treated with TMP/SMT. Patients with buboes responded equally well to both treatments. Of 100 H ducreyi strains tested, all were susceptible to both 0.25 mg/l enoxacin and the combination of 0.25 mg/l TMP and 5 mg/l SMT. Although most men treated with either regimen were cured, neither regimen appeared to be the optimum treatment for chancroid. This study shows the efficacy of enoxacin for a soft tissue infection caused by Gram negative organisms.
杜克雷嗜血杆菌对抗菌药物的耐药性不断增加,因此有必要进一步试验用于治疗软下疳的新型抗菌药物。依诺沙星对杜克雷嗜血杆菌具有优异的体外活性,因此开展了一项随机临床试验,比较每12小时服用400毫克依诺沙星的三种剂量方案与单次服用640/3200毫克甲氧苄啶/磺胺甲恶唑(TMP/SMT)的效果。在该研究纳入的169名男性中,86人接受依诺沙星治疗,83人接受TMP/SMT治疗。接受依诺沙星治疗的73名男性中有65人溃疡得到改善或治愈,接受TMP/SMT治疗的70名男性中有57人溃疡得到改善或治愈。这种差异不显著。治疗72小时后,接受依诺沙星治疗的77名男性中有72人溃疡中的杜克雷嗜血杆菌被根除,接受TMP/SMT治疗的74名男性中有67人溃疡中的杜克雷嗜血杆菌被根除。患有腹股沟淋巴结炎的患者对两种治疗的反应同样良好。在测试的100株杜克雷嗜血杆菌菌株中,所有菌株对0.25毫克/升的依诺沙星以及0.25毫克/升的TMP和5毫克/升的SMT的组合均敏感。虽然接受这两种治疗方案的大多数男性都被治愈,但两种方案似乎都不是软下疳的最佳治疗方法。这项研究表明了依诺沙星对革兰氏阴性菌引起的软组织感染的疗效。