Murase T
Department of Internal Medicine, Second Tokyo National Hospital.
Kansenshogaku Zasshi. 1995 Jan;69(1):28-32. doi: 10.11150/kansenshogakuzasshi1970.69.28.
Fifty-three granulocytopenic patients were studied in a randomized trial comparing trimethoprim-sulfamethoxaxole (ST) alone with ST + ciprofloxacin (CPFX) for prevention of bacterial infections. Seventeen febrile episodes occurred in 24 patients receiving ST alone, and 9 febrile episodes occurred in 29 patients receiving ST + CPFX. ST + CPFX was significantly effective than ST alone (p < 0.005). Although ST alone was effective to prevent infections in moderately granulocytopenic patients, it could not prevent infections in severely granulocytopenic patients whose minimal granulocyte count was less than 250/microliters during prophylactic treatment. In contrast, ST + CPFX was effective in severely as well as in moderately granulocytopenic patients. Clinically significant adverse reactions were not observed in both regimens. These results suggest that combination with ST and CPFX is more efficacious than ST alone for the prevention of bacterial infections in granulocytopenic patients.
在一项随机试验中,对53例粒细胞减少患者进行了研究,比较单独使用甲氧苄啶 - 磺胺甲恶唑(ST)与ST + 环丙沙星(CPFX)预防细菌感染的效果。单独接受ST治疗的24例患者发生了17次发热事件,接受ST + CPFX治疗的29例患者发生了9次发热事件。ST + CPFX比单独使用ST显著有效(p < 0.005)。虽然单独使用ST对预防中度粒细胞减少患者的感染有效,但它不能预防预防性治疗期间最低粒细胞计数低于250/微升的严重粒细胞减少患者的感染。相比之下,ST + CPFX对严重和中度粒细胞减少患者均有效。两种治疗方案均未观察到具有临床意义的不良反应。这些结果表明,对于预防粒细胞减少患者的细菌感染,ST与CPFX联合使用比单独使用ST更有效。