Salam M A, Bennish M L
Dhaka Treatment Centre, International Centre for Diarrhoeal Disease Research, Bangladesh.
J Pediatr. 1988 Nov;113(5):901-7. doi: 10.1016/s0022-3476(88)80029-5.
We compared nalidixic acid, 55 mg/kg/day, with ampicillin, 100 mg/kg/day, both given orally for 5 days, in the treatment of children with dysentery caused by shigellosis. All patients entered into the study had illness of less than 72 hours' duration and no prior allopathic drug therapy. Treatment was randomized and administered in double-blind fashion. Patients initially treated with ampicillin who were infected with a Shigella strain resistant to ampicillin were considered as a separate group (ampicillin-R). All isolates were susceptible to nalidixic acid. Similar percentages of patients treated with nalidixic acid (26/32, 81%) and with ampicillin (17/22, 77%) were clinically cured by the end of therapy; the rate in ampicillin-R (3/14, 21%) patients was significantly lower (p less than 0.001). Stool frequency in patients treated with nalidixic acid was significantly less than for ampicillin-treated or ampicillin-R patients during the final 3 study days. All patients treated with nalidixic acid and ampicillin had Shigella eradicated from their stool by day 3, compared with 77% (10/13) of ampicillin-R patients (p less than 0.05, ampicillin-R vs nalidixic acid or ampicillin). We conclude that nalidixic acid is an effective alternative to ampicillin in the treatment of shigellosis caused by nalidixic acid-susceptible strains.
我们比较了萘啶酸（55毫克/千克/天）和氨苄西林（100毫克/千克/天），二者均口服给药，疗程为5天，用于治疗志贺菌病引起的痢疾患儿。所有进入该研究的患者病程均小于72小时，且此前未接受过对抗疗法药物治疗。治疗采用随机分组并以双盲方式给药。最初接受氨苄西林治疗但感染了对氨苄西林耐药的志贺菌菌株的患者被视为一个单独的组（氨苄西林耐药组）。所有分离株对萘啶酸敏感。到治疗结束时，接受萘啶酸治疗的患者（26/32，81%）和接受氨苄西林治疗的患者（17/22，77%）临床治愈的比例相似；氨苄西林耐药组患者（3/14，21%）的治愈率显著更低（p<0.001）。在研究的最后3天，接受萘啶酸治疗的患者的大便次数显著少于接受氨苄西林治疗的患者或氨苄西林耐药组患者。到第3天时，所有接受萘啶酸和氨苄西林治疗的患者大便中的志贺菌均被清除，相比之下，氨苄西林耐药组患者中有77%（10/13）的患者大便中的志贺菌被清除（p<0.05，氨苄西林耐药组与萘啶酸组或氨苄西林组相比）。我们得出结论，在治疗对萘啶酸敏感菌株引起的志贺菌病方面，萘啶酸是氨苄西林的一种有效替代药物。
