Chaudhary S, Bilinsky S A, Hennessy J L, Soler S M, Wallace S E, Schacht C M, Bisno A L
J Pediatr. 1985 Mar;106(3):481-6. doi: 10.1016/s0022-3476(85)80687-9.
To improve the bacteriologic and clinical cure rates of streptococcal pharyngitis, 79 children were randomly assigned to receive penicillin V alone for 10 days (39 patients) or penicillin for the same duration and rifampin during the last 4 days of penicillin therapy (40 patients). Eleven patients given penicillin had evidence of bacteriologic failure (including eight with relapse of clinical illness) on repeat cultures done 4 to 7 days after treatment, whereas there were no failures in children given combination therapy (P = 0.0015). All eight symptomatic children improved with penicillin-rifampin therapy and subsequent cultures were negative, whereas three asymptomatic children continued to harbor group A streptococci even after combination therapy. Antibody response by antistreptolysin O or antideoxyribonuclease B assay was seen in 50.6% of patients; the antibody responses in both groups were comparable. These results show that addition of rifampin to the penicillin regimen improves the clinical and bacteriologic cure rates in children with streptococcal pharyngitis.
为提高链球菌性咽炎的细菌学治愈率和临床治愈率，79名儿童被随机分为两组，一组39例单独接受10天的青霉素V治疗，另一组40例接受相同疗程的青霉素治疗，并在青霉素治疗的最后4天加用利福平。接受青霉素治疗的11例患者在治疗后4至7天复查培养时有细菌学治疗失败的证据（包括8例临床疾病复发），而联合治疗组的儿童没有治疗失败的情况（P = 0.0015）。所有8例有症状的儿童经青霉素 - 利福平治疗后病情好转，随后的培养结果为阴性，而3例无症状儿童即使在联合治疗后仍携带A组链球菌。通过抗链球菌溶血素O或抗脱氧核糖核酸酶B检测发现50.6%的患者有抗体反应；两组的抗体反应相当。这些结果表明，在青霉素治疗方案中加用利福平可提高链球菌性咽炎患儿的临床和细菌学治愈率。
