Masur H, Murray H W, Roberts R B
Antimicrob Agents Chemother. 1978 Sep;14(3):457-61. doi: 10.1128/AAC.14.3.457.
Semisynthetic penicillinase-resistant penicillins are recommended for therapy of Staphylococcus aureus endocarditis, but evaluation of the efficacy and safety of individual agents has received little attention. At The New York Hospital, 11 heroin addicts and 5 nonaddicts were treated with nafcillin. The 11 addicts did well clinically, but four of the five nonaddicts had severe complications, and three of them died. Important adverse reactions to nafcillin occurred in two patients: one developed leukopenia, and one developed an extensive rash. Methicillin was employed to treat two heroin addicts and four nonaddicts. Five of the six patients were cured bacteriologically, but three patients developed nephritis and one patient developed an extensive rash. Nafcillin appears to be highly efficacious for the treatment of S. aureus endocarditis, yielding results at least equal to those obtained with other drugs. Because adverse reactions appear to occur more frequently with methicillin than with nafcillin, we regard nafcillin as the preferable penicillinase-resistant penicillin for the treatment of S. aureus endocarditis.
半合成耐青霉素酶青霉素被推荐用于治疗金黄色葡萄球菌性心内膜炎，但对个别药物的疗效和安全性评估却很少受到关注。在纽约医院，11名海洛因成瘾者和5名非成瘾者接受了萘夫西林治疗。11名成瘾者临床情况良好，但5名非成瘾者中有4人出现严重并发症，其中3人死亡。两名患者出现了萘夫西林的重要不良反应：1人出现白细胞减少，1人出现广泛皮疹。用甲氧西林治疗了2名海洛因成瘾者和4名非成瘾者。6名患者中有5名细菌学治愈，但3名患者出现肾炎，1名患者出现广泛皮疹。萘夫西林似乎对治疗金黄色葡萄球菌性心内膜炎高度有效，其疗效至少与其他药物相当。由于甲氧西林出现不良反应的频率似乎高于萘夫西林，我们认为萘夫西林是治疗金黄色葡萄球菌性心内膜炎更合适的耐青霉素酶青霉素。
