用甲氧苄啶、甲氧苄啶 - 磺胺甲恶唑或安慰剂治疗实验性诱导的产肠毒素大肠杆菌腹泻。

Treatment of experimentally induced enterotoxigenic Escherichia coli diarrhea with trimethoprim, trimethoprim-sulfamethoxazole, or placebo.

作者信息

Black R E, Levine M M, Clements M L, Cisneros L, Daya V

出版信息

Rev Infect Dis. 1982 Mar-Apr;4(2):540-5. doi: 10.1093/clinids/4.2.540.

DOI:10.1093/clinids/4.2.540

Abstract

In a double-blind study of the treatment of disease caused by enterotoxigenic Escherichia coli (ETEC), diarrhea was induced in volunteers with a trimethoprim (TMP)- and sulfamethoxazole (SMZ)-susceptible strain of E. coli that produces both heat-stable and heat-labile toxin. III volunteers were then treated with TMP, TMP-SMZ, or placebo. Volunteers treated with both TMP alone and the TMP-SMZ combination showed a substantial decrease in the duration and severity of the illness, as compared with the placebo-treated controls. TMP-resistant (MIC, 3.1-12.5 micrograms/ml) ETEC were isolated from stool cultures of five of 10 TMP-treated volunteers and none of 10 TMP-SMZ-treated volunteers after 48 hr of therapy, and in two volunteers the appearance of resistant organisms was associated with a clinical relapse. These data suggest that the TMP-SMZ combination should be evaluated in field trials to determine its usefulness as an adjunct to replacement of fluid and electrolytes in the therapy of ETEC diarrhea.

摘要

在一项关于产肠毒素大肠杆菌（ETEC）所致疾病治疗的双盲研究中，用一种对甲氧苄啶（TMP）和磺胺甲恶唑（SMZ）敏感、能产生耐热和不耐热毒素的大肠杆菌菌株在志愿者中诱发腹泻。然后，111名志愿者分别接受TMP、TMP-SMZ或安慰剂治疗。与接受安慰剂治疗的对照组相比，单独接受TMP治疗以及接受TMP-SMZ联合治疗的志愿者的疾病持续时间和严重程度均大幅降低。治疗48小时后，在10名接受TMP治疗的志愿者中有5人的粪便培养物中分离出对TMP耐药（最低抑菌浓度，3.1 - 12.5微克/毫升）的ETEC，而在10名接受TMP-SMZ治疗的志愿者中均未分离出；在两名志愿者中，耐药菌的出现与临床复发有关。这些数据表明，应在现场试验中评估TMP-SMZ联合用药，以确定其在ETEC腹泻治疗中作为补充液体和电解质的辅助药物的有效性。