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交沙霉素治疗儿童支原体肺炎的临床评价

[Clinical evaluation of josamycin for the treatment of Mycoplasma pneumonia in children].

作者信息

Motohiro T, Tanaka K, Koga T, Shimada Y, Tomita N, Sakata Y, Fujimoto T, Nishiyama T, Ishimoto K, Tominaga K

出版信息

Jpn J Antibiot. 1983 Jun;36(6):1359-76.

PMID:6418931
Abstract

Thirty-one strains of Mycoplasma pneumoniae were tested for drug sensitivity to both josamycin (JM) and erythromycin (EM), to evaluate the efficacy of JM for mycoplasmal pneumonia in children. In addition to the sensitivity tests of 31 M. pneumoniae strains against JM and EM, 50 patients, between the ages of 3 years 1 month and 13 years 3 months, suspected of suffering from mycoplasmal pneumonia were treated with 50 or 200 mg JM tablets at an average daily dose of 43.1 mg/kg t.i.d. or b.i.d. for an average period of 14 days; an additional 31 patients between the ages of 2 years 9 months and 11 years, suspected of suffering from this disease were treated with tablet or dry syrup of EM, with the exception of EM estolate, t.i.d. or b.i.d. at an average daily dose of 72.5 mg/kg for an average period of 15 days. Patients were selected in 37 and 22 mycoplasmal pneumonic patients respectively for JM and EM. Clinical and bacteriological effects, efficacy and side effects of the drugs on this disease were studied and the following results were obtained. Drug sensitivity test Of all 31 strains tested for JM sensitivity the populations which exhibited 0.125 mcg/ml were most abundant (18/31, 58.1%) and MIC pattern of all strains were distributed from 0.0313 to 0.125 mcg/ml. In the EM group, 61.3% (19/31) of the populations were sensitive at 0.015 mcg/ml, exhibiting the dominant distribution pattern and MIC range of all organism varied from 0.0078 to 0.0313 mcg/ml. Resistant strains were found to neither JM nor EM. EM was approximately 2 to 10 times more active than JM in MIC evaluation. Clinical effects of JM by daily doses Clinical effects relative to the daily dose were evaluated in 3, 7, 10 days after administration of drugs. The response was favorable, according to assessments of the attending doctors, in 96.7, 100% and 95.8% of the patient group given JM in a daily dose of 40-49 mg/kg, the group to which the largest number of patients belonged. Similar favorable results were obtained by the assessments of Evaluation Committee, showing 86.7, 96.7% and 100% of favorable response. Upon comparison, in the same interval, of these results with those of the groups given EM in a daily dose of 50 mg/kg, the group in which the largest number of patients were seen, there was no significant difference in the assessments either of the attending doctors or of the Evaluation Committee.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

检测了31株肺炎支原体对交沙霉素(JM)和红霉素(EM)的药敏情况,以评估JM对儿童支原体肺炎的疗效。除了对31株肺炎支原体进行JM和EM的药敏试验外,选取50例年龄在3岁1个月至13岁3个月之间疑似支原体肺炎的患者,给予JM片50或200mg,平均日剂量43.1mg/kg,每日3次或2次,平均疗程14天;另外选取31例年龄在2岁9个月至11岁之间疑似该病的患者,给予除无味红霉素外的EM片或干糖浆,每日3次或2次,平均日剂量72.5mg/kg,平均疗程15天。分别选取37例和22例支原体肺炎患者使用JM和EM。研究了药物对该病的临床和细菌学效果、疗效及副作用,获得以下结果。药物敏感性试验:在所有检测JM敏感性的31株菌株中,显示0.125mcg/ml的菌群最为丰富(18/31,58.1%),所有菌株的MIC模式分布在0.0313至0.125mcg/ml之间。在EM组中,61.3%(19/31)的菌群对0.015mcg/ml敏感,呈现优势分布模式,所有菌株的MIC范围在0.0078至0.0313mcg/ml之间。未发现对JM和EM耐药的菌株。在MIC评估中,EM的活性比JM高约2至10倍。JM每日剂量的临床效果:在给药后3、7、10天评估相对于每日剂量的临床效果。根据主治医生的评估,每日剂量为40 - 49mg/kg的JM患者组(患者数量最多的组),在这些时间点的有效率分别为96.7%、100%和95.8%。评估委员会的评估也得到了类似的良好结果,显示有效率分别为86.7%、96.7%和100%。相比之下,在相同时间段内,将这些结果与每日剂量为50mg/kg的EM患者组(患者数量最多的组)的结果进行比较,主治医生和评估委员会的评估均无显著差异。(摘要截断于400字)

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