Heseltine P N, Corrado M L
Am J Med. 1987 Jun 26;82(6B):88-92. doi: 10.1016/0002-9343(87)90626-7.
Norfloxacin, a new oral fluoroquinolone, has a spectrum of activity and pharmacology that suggest it may be useful in certain infections in which other agents are inactive or have anticipated toxicity. This report is an analysis of 61 "compassionate" requests for norfloxacin that resulted in 42 treatment courses. The reasons for use included multiresistant pathogens susceptible only to norfloxacin in 42 percent, failure of prior use of a marketed antibiotic in 34 percent, and preferred use of norfloxacin due to anticipated toxicity from an aminoglycoside in 32 percent or from other agents in 9 percent. Infections treated included 29 complicated urinary tract infections, 23 involving multiresistant Pseudomonas species, and 10 gastrointestinal infections, seven involving Salmonella species. Prophylaxis of infection was initiated in three neutropenic patients with leukemia. The duration of norfloxacin therapy ranged from eight to 28 days at a daily dose of 800 mg (400 mg twice daily). Norfloxacin treatment resulted in clinical cure or improvement in 84 percent of patients and eradicated the etiologic pathogen(s) 52 percent of the time. In Pseudomonas species infections, cure was achieved in 29 percent of patients and 57 percent showed improvement; the pathogen was eradicated in 43 percent of these infections. Resistance developed in four of the eight Pseudomonas species infections that persisted. Based on a review of compassionate therapy cases, it appears that norfloxacin is effective oral therapy for many complicated urinary and gastrointestinal infections for which other agents cannot be used because of bacterial resistance or anticipated toxicity.
诺氟沙星是一种新型口服氟喹诺酮类药物，其抗菌谱和药理学特性表明，它可能对某些其他药物无效或有预期毒性的感染有用。本报告分析了61例关于诺氟沙星的“同情用药”申请，共产生了42个治疗疗程。使用原因包括：42%的患者感染了仅对诺氟沙星敏感的多重耐药病原体；34%的患者之前使用市售抗生素治疗失败；32%的患者因预期氨基糖苷类药物或9%的患者因预期其他药物会产生毒性而优先选择诺氟沙星。治疗的感染包括29例复杂性尿路感染、23例涉及多重耐药假单胞菌属的感染以及10例胃肠道感染，其中7例涉及沙门氏菌属。对3例白血病中性粒细胞减少患者进行了感染预防。诺氟沙星治疗疗程为8至28天，每日剂量为800毫克（400毫克，每日两次）。诺氟沙星治疗使84%的患者获得临床治愈或病情改善，52%的患者病原体被根除。在假单胞菌属感染中，29%的患者治愈，57%的患者病情改善；43%的此类感染病原体被根除。在持续的8例假单胞菌属感染中有4例出现耐药。基于对同情用药治疗病例的回顾，诺氟沙星似乎是许多复杂性泌尿和胃肠道感染的有效口服治疗药物，对于这些感染，由于细菌耐药性或预期毒性，其他药物无法使用。
