Puddicombe J B, Wali S S, Greenwood B M
Trans R Soc Trop Med Hyg. 1984;78(3):399-403. doi: 10.1016/0035-9203(84)90132-9.
During an epidemic of meningococcal meningitis 86 patients with symptoms and signs of meningitis were treated with a single intramuscular injection of a long-acting oily preparation of chloramphenicol (Tifomycine). Treatment was given by auxiliary medical staff who worked in four separate village dispensaries under the supervision of the local medical officer. The clinical response to treatment was satisfactory; 79 of 86 patients (92%) recovered fully with few residual disabilities. There were five deaths (5.8%) but a definite diagnosis of meningococcal meningitis was established in only one of these patients. Treatment was changed because of a poor clinical response in two further patients. Diagnosis was eventually proved in 45 patients (52%). The response to treatment of patients in this group was similar to that observed in the remaining 41 patients. The results of this preliminary study show that a single dose injection of a long-acting chloramphenicol is of value in the management of epidemics of meningococcal meningitis in rural areas because patients can be treated locally and early in their village dispensaries, thereby minimizing the need to transport them to urban hospitals which are often distant and congested.
在一次脑膜炎球菌性脑膜炎流行期间，86例有脑膜炎症状和体征的患者接受了单次肌肉注射长效氯霉素油剂（替霉素）治疗。治疗由辅助医务人员进行，他们在当地医务人员的监督下，在四个独立的乡村诊疗所工作。治疗的临床反应令人满意；86例患者中有79例（92%）完全康复，几乎没有残留残疾。有5例死亡（5.8%），但其中只有1例确诊为脑膜炎球菌性脑膜炎。另外两名患者因临床反应不佳而更换了治疗方法。最终在45例患者（52%）中证实了诊断。该组患者的治疗反应与其余41例患者观察到的反应相似。这项初步研究的结果表明，单次注射长效氯霉素在农村地区脑膜炎球菌性脑膜炎流行的管理中具有价值，因为患者可以在其乡村诊疗所就地早期接受治疗，从而最大限度地减少了将他们转运到往往距离远且拥挤的城市医院的必要性。
