Feldman S, Doolittle M, Lott L, Roberson P, Hughes W T
J Pediatr. 1985 Jun;106(6):995-1000. doi: 10.1016/s0022-3476(85)80257-2.
We report the hematologic changes in 90 black children who were randomized to receive a 10-day course of either trimethoprim-sulfamethoxazole (TMP-SMZ) or amoxicillin as therapy for acute otitis media. Absolute neutrophil counts less than 1500/mm3 developed at least once during the 23-day evaluation in 28 (57%) of the 49 children given TMP-SMZ and in 22 (54%) of the 41 who received amoxicillin. Incidence of leukopenia, thrombocytopenia, and anemia was negligible in both groups. Pancytopenia did not occur in any child. Absolute neutrophil counts had increased to greater than 1500/mm3 by the end of the study period in all of the patients but six, whose recovery required an additional 1 to 63 days. Decreased neutrophil counts in antibiotic-treated subjects remained within the range of findings for healthy black children, suggesting that a count less than 1500/mm3 may be an inappropriate criterion for an adverse drug effect. Neither TMP-SMZ nor amoxicillin produced hematologic effects that would detract from their continued use in children with infections caused by antibiotic-susceptible organisms.
我们报告了90名黑人儿童的血液学变化，这些儿童被随机分配接受为期10天的甲氧苄啶-磺胺甲恶唑（TMP-SMZ）或阿莫西林治疗急性中耳炎。在接受TMP-SMZ治疗的49名儿童中，有28名（57%）在23天的评估期间至少有一次绝对中性粒细胞计数低于1500/mm³，在接受阿莫西林治疗的41名儿童中，有22名（54%）出现这种情况。两组中白细胞减少、血小板减少和贫血的发生率都可以忽略不计。所有儿童均未发生全血细胞减少。在研究期结束时，除6名患者外，所有患者的绝对中性粒细胞计数均已升至高于1500/mm³，这6名患者的恢复需要额外1至63天。抗生素治疗患者中性粒细胞计数的下降仍在健康黑人儿童的检查结果范围内，这表明低于1500/mm³的计数可能不是判断药物不良反应的合适标准。TMP-SMZ和阿莫西林均未产生会影响其继续用于治疗由抗生素敏感菌引起感染的儿童的血液学效应。
