Khan W A, Begum M, Salam M A, Bardhan P K, Islam M R, Mahalanabis D
Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Trans R Soc Trop Med Hyg. 1995 Jan-Feb;89(1):103-6. doi: 10.1016/0035-9203(95)90675-4.
To compare the efficacy of ciprofloxacin, erythromycin, nalidixic acid and pivmecillinam in the treatment of tetracycline-resistant strains of Vibrio cholerae O1 in adults, a randomized, open, clinical trial was conducted. A tetracycline group was used for comparison. Seventy-five adult men infected with V. cholerae O1 were randomly assigned to receive either 400 mg pivmecillinam or 500 mg of one of each of the other drugs. Ciprofloxacin was given every 12 h and the others every 6 h for 3 d. The mean total stool volume per kg was 155 mL for the ciprofloxacin group, 212 mL for the erythromycin and pivmecillinam groups, 246 mL for nalidixic acid, and 293 mL for tetracycline. The difference between ciprofloxacin and tetracycline was significant (P = 0.045). After 72 h, diarrhoea had stopped in 14 patients (93%) in the ciprofloxacin group and 12 (80%) in the erythromycin group, compared to 5 (42%) of those receiving tetracycline (P = 0.006 and 0.049, respectively). Bacteriological clearance was 100% at 24 h in patients treated with ciprofloxacin compared to 20% and 8.3% (P < 0.001 for both comparisons) in the erythromycin and tetracycline groups. Ciprofloxacin in conjunction with appropriate fluid therapy was the most effective treatment for cholera in adults; erythromycin was the next best.
为比较环丙沙星、红霉素、萘啶酸和匹美西林对成人四环素耐药性霍乱弧菌O1菌株的治疗效果，进行了一项随机、开放的临床试验。设立四环素组作为对照。75名感染霍乱弧菌O1的成年男性被随机分配接受400mg匹美西林或500mg其他药物中的一种。环丙沙星每12小时给药一次，其他药物每6小时给药一次，持续3天。环丙沙星组每千克体重的平均粪便总量为155mL，红霉素和匹美西林组为212mL，萘啶酸组为246mL，四环素组为293mL。环丙沙星与四环素之间的差异具有统计学意义（P = 0.045）。72小时后，环丙沙星组14名患者（93%）腹泻停止，红霉素组12名患者（80%）腹泻停止，而接受四环素治疗的患者中只有5名（4）腹泻停止（P分别为0.006和0.049）。环丙沙星治疗的患者在24小时时细菌清除率为100%，而红霉素组和四环素组分别为20%和8.3%（两组比较P均<0.001）。环丙沙星联合适当的液体疗法是治疗成人霍乱最有效的方法；红霉素次之。
