Asmar B I, Maqbool S, Dajani A S
Am J Dis Child. 1981 Dec;135(12):1100-3. doi: 10.1001/archpedi.1981.02130360008004.
The development of hematologic abnormalities was prospectively evaluated in 50 children treated for ten days each with oral trimethoprim-sulfamethoxazole and compared with a control group of 20 children with similar infections treated with amoxicillin trihydrate. Neutropenia (polymorphonuclear neutrophilic leukocyte counts, less than or equal to 1,500/cu mm) developed in 17 (34%) of the 50 children treated with trimethoprim-sulfamethoxazole compared with one (5%) in the control group of 20 children (P less than 0.001). Thrombocytopenia (platelet count, less than 150,000/cu mm) developed in six (12%) of the children treated with trimethoprim-sulfamethoxazole, but it did not develop in any of the amoxicillin-treated children (P less than .01). Neutropenia occurred mostly during the first week of treatment and lasted a mean of 8.9 days. Thrombocytopenia was noted between the seventh and 16th day (mean, 10.3 days) and lasted a mean of 12.7 days. Both side effects resolved spontaneously without ill effects. Children treated with oral trimethoprim-sulfamethoxazole should be followed up with biweekly leukocyte and platelet counts, and treatment should be discontinued if severe neutropenia or thrombocytopenia develops.
对50名接受口服甲氧苄啶-磺胺甲恶唑治疗10天的儿童的血液学异常发展情况进行了前瞻性评估，并与20名接受三水合阿莫西林治疗的类似感染儿童的对照组进行了比较。在接受甲氧苄啶-磺胺甲恶唑治疗的50名儿童中，有17名（34%）出现了中性粒细胞减少（多形核中性粒细胞计数小于或等于1500/立方毫米），而在20名儿童的对照组中只有1名（5%）出现（P小于0.001）。接受甲氧苄啶-磺胺甲恶唑治疗的儿童中有6名（12%）出现了血小板减少（血小板计数小于150000/立方毫米），但在接受阿莫西林治疗的儿童中均未出现（P小于0.01）。中性粒细胞减少大多发生在治疗的第一周，平均持续8.9天。血小板减少在第7天至第16天被发现（平均10.3天），平均持续12.7天。两种副作用均自行缓解，无不良影响。接受口服甲氧苄啶-磺胺甲恶唑治疗的儿童应每两周进行白细胞和血小板计数随访，如果出现严重中性粒细胞减少或血小板减少，应停止治疗。
