Butler T, Rumans L, Arnold K
Rev Infect Dis. 1982 Mar-Apr;4(2):551-61. doi: 10.1093/clinids/4.2.551.
Chloramphenicol remains the drug of choice for the treatment of typhoid fever in most areas despite the risks of relapses and toxicity. In a comparison of the efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ) and chloramphenicol against typhoid fever, 60 patients in Indonesia were randomly assigned to receive either TMP-SMZ (320 mg of TMP and 1,600 mg of SMZ daily) or chloramphenicol (2 g daily) for 14 days. TMP-SMZ was significantly more effective in sterilizing the blood, but the two drugs were equally effective with regard to relapse rate, frequency of prolonged fever, and mortality. Use of TMP-SMZ in Vietnam for the treatment of typhoid fever caused by chloramphenicol-resistant Salmonella typhi showed that TMP-SMZ is as effective as ampicillin. Likewise, a review of other published reports suggests that TMP-SMZ has an overall record in the treatment of typhoid fever that is equal to or better than the records of other available drugs. TMP-SMZ has emerged as a satisfactory alternative to chloramphenicol for the treatment of typhoid fever and should be especially useful in areas where chloramphenicol-resistant S. typhi has been isolated.
尽管存在复发和毒性风险，但在大多数地区，氯霉素仍然是治疗伤寒热的首选药物。在一项比较甲氧苄啶-磺胺甲恶唑（TMP-SMZ）和氯霉素治疗伤寒热疗效的研究中，印度尼西亚的60名患者被随机分配接受TMP-SMZ（每日320毫克TMP和1600毫克SMZ）或氯霉素（每日2克）治疗14天。TMP-SMZ在清除血液中的病菌方面明显更有效，但两种药物在复发率、持续发热频率和死亡率方面效果相当。在越南，使用TMP-SMZ治疗由耐氯霉素的伤寒沙门氏菌引起的伤寒热表明，TMP-SMZ与氨苄西林效果相当。同样，对其他已发表报告的综述表明，TMP-SMZ在治疗伤寒热方面的总体记录与其他现有药物相当或更好。TMP-SMZ已成为治疗伤寒热的一种令人满意的氯霉素替代品，在已分离出耐氯霉素伤寒沙门氏菌的地区应特别有用。
