DuPont H L
University of Texas Medical School/University of Texas School of Public Health, Houston.
Drugs. 1993;45 Suppl 3:119-24. doi: 10.2165/00003495-199300453-00020.
The quinolones possess a high degree of in vitro activity against enteric bacteria, including Salmonella. This observation, coupled with the limitations of current antityphoid agents, has resulted in the evaluation of quinolones in the therapy of S. typhi infection, including both enteric fever and chronic intestinal carriage. In open uncontrolled trials, norfloxacin, ciprofloxacin, ofloxacin and pefloxacin have been used successfully to treat more than 200 patients with culture-proven typhoid fever. In comparative clinical trials, ciprofloxacin, ofloxacin, pefloxacin or fleroxacin were equivalent or superior to standard antityphoid therapy. In separate studies, norfloxacin and ciprofloxacin were each effective in eliminating intestinal excretion of S. typhi in chronic carriers. Because of increasing resistance worldwide to conventional antityphoid drugs, and in view of the efficacy of the quinolones in the therapy of both typhoid fever and typhoid intestinal carriage, these drugs may become the treatment of choice for these important enteric infections.
喹诺酮类药物对包括沙门氏菌在内的肠道细菌具有高度的体外活性。这一观察结果，再加上当前抗伤寒药物的局限性，使得人们对喹诺酮类药物在治疗伤寒杆菌感染（包括肠热症和慢性肠道带菌状态）方面进行了评估。在开放的非对照试验中，诺氟沙星、环丙沙星、氧氟沙星和培氟沙星已成功用于治疗200多名经培养证实的伤寒热患者。在比较临床试验中，环丙沙星、氧氟沙星、培氟沙星或氟罗沙星等同于或优于标准抗伤寒疗法。在单独的研究中，诺氟沙星和环丙沙星各自在消除慢性带菌者肠道中的伤寒杆菌排泄物方面均有效。由于全球范围内对传统抗伤寒药物的耐药性不断增加，并且鉴于喹诺酮类药物在治疗伤寒热和伤寒肠道带菌状态方面的疗效，这些药物可能会成为这些重要肠道感染的首选治疗药物。
