Rodriguez W J, Schwartz R H, Khan W N, Gold A J
Pediatr Infect Dis. 1983 Jan-Feb;2(1):27-9. doi: 10.1097/00006454-198301000-00007.
In patients with acute otitis media who had failed to improve with ampicillin therapy, 35% of Haemophilus strains isolated from the middle ear were ampicillin-resistant. Twenty-nine children (24 of whom had failed to respond to ampicillin) were treated with 40 mg erythromycin ethylsuccinate per kg per day and 100 to 150 mg sulfisoxazole per kg per day. Middle ear exudate was cultured on chocolate and 5% sheep blood agar. Twenty-three of 29 Haemophilus isolates were nontypable, 10% (3 children) were type b, 2 were Haemophilus parainfluenzae and one was not typed. All strains were resistant to ampicillin by disc susceptibility testing, and 28 of 29 strains produced beta-lactamase. The minimal inhibitory concentration of ampicillin for 15 strains ranged from 3.12 to 100 micrograms/ml (median, 6.25 micrograms/ml). The erythromycin ethylsuccinate and acetyl sulfisoxazole combination was effective in treatment of acute otitis media secondary to ampicillin-resistant Haemophilus influenzae. After 10 days of erythromycin ethylsuccinate-sulfisoxazole therapy, 18 patients had normal tympanic membranes. Of 11 with middle ear effusion, 7 cleared, 3 had recurrent otitis media within 1 month and 1 had persistent otitis media with effusion. Our experience suggests the efficacy of this combination in otitis media caused by ampicillin-resistant H. influenzae.
在接受氨苄西林治疗但病情未改善的急性中耳炎患者中，从中耳分离出的嗜血杆菌菌株有35%对氨苄西林耐药。29名儿童（其中24名对氨苄西林无反应）接受了每日每千克体重40毫克琥乙红霉素和每日每千克体重100至150毫克磺胺异恶唑的治疗。中耳渗出液在巧克力琼脂和5%羊血琼脂上培养。29株嗜血杆菌分离株中，23株无法分型，10%（3名儿童）为b型，2株为副流感嗜血杆菌，1株未分型。通过纸片药敏试验，所有菌株均对氨苄西林耐药，29株菌株中有28株产生β-内酰胺酶。15株菌株对氨苄西林的最低抑菌浓度范围为3.12至100微克/毫升（中位数为6.25微克/毫升）。琥乙红霉素和乙酰磺胺异恶唑联合用药对耐氨苄西林流感嗜血杆菌引起的急性中耳炎治疗有效。接受琥乙红霉素-磺胺异恶唑治疗10天后，18例患者鼓膜恢复正常。11例有中耳积液的患者中，7例积液清除，3例在1个月内复发中耳炎，1例持续存在中耳积液。我们的经验表明，这种联合用药对耐氨苄西林流感嗜血杆菌引起的中耳炎有效。
