Tran T H, Bethell D B, Nguyen T T, Wain J, To S D, Le T P, Bui M C, Nguyen M D, Pham T T, Walsh A L
Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam.
Clin Infect Dis. 1995 Apr;20(4):917-23.
In recent years, multiresistant strains of Salmonella typhi have emerged in many tropical countries. These strains remain highly sensitive to the fluoroquinolone antibiotics, although use of these drugs by children is considered contraindicated because of their reported toxicity in the cartilage of experimental animals. In a paired, open, randomized study during an epidemic of multidrug-resistant typhoid in southern Vietnam, two short-course ofloxacin regimens (15 mg/kg daily for 3 days and 10 mg/kg daily for 5 days) were compared for the treatment of uncomplicated typhoid fever. Of 438 patients enrolled (of whom 286 were < or = 14 years old), 228 had blood cultures positive for Salmonella species (S. typhi, 207; S. paratyphi A, 19; and S. choleraesuis, 2). There was one treatment failure in a patient who took only one dose of ofloxacin. Otherwise, both regimens were completely effective; there were no proven carriers, and there was no evidence of toxicity, particularly in children. A 3-day course of ofloxacin proved to be safe and highly effective in the treatment of uncomplicated, multidrug-resistant typhoid fever.
近年来，许多热带国家出现了多重耐药的伤寒沙门氏菌菌株。这些菌株对氟喹诺酮类抗生素仍高度敏感，不过由于据报道这类药物对实验动物的软骨有毒性，儿童使用这些药物被视为禁忌。在越南南部一场多重耐药伤寒流行期间进行的一项配对、开放、随机研究中，比较了两种短疗程氧氟沙星治疗方案（每日15毫克/千克，共3天；以及每日10毫克/千克，共5天）对单纯性伤寒热的治疗效果。在纳入的438例患者中（其中286例年龄小于或等于14岁），228例血培养出沙门氏菌属阳性（伤寒沙门氏菌207例；甲型副伤寒沙门氏菌19例；猪霍乱沙门氏菌2例）。有1例仅服用一剂氧氟沙星的患者治疗失败。除此之外，两种方案均完全有效；没有出现确诊的带菌者，也没有毒性证据，尤其是在儿童中。事实证明，3天疗程的氧氟沙星治疗单纯性多重耐药伤寒热安全且高效。
