Alam A N, Islam M R, Hossain M S, Mahalanabis D, Hye H K
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Scand J Gastroenterol. 1994 Apr;29(4):313-7. doi: 10.3109/00365529409094842.
The efficacy of oral pivmecillinam was compared with nalidixic acid in the treatment of acute shigellosis in children 1-8 years of age. In a double-blind trial we studied 80 comparable children with bloody diarrhoea of less than 3 days' duration. Shigella spp. was isolated in 71 children. Patients were randomly assigned to receive either pivmecillinam, 50 mg/kg.day, or nalidixic acid, 60 mg/kg.day, both given orally for 5 days. The stool frequency decreased progressively in both treatment groups. Nalidixic acid failed to eradicate Shigella species in 10 patients, compared with three in the pivmecillinam group (p = 0.04). Similarly, clinical failure was observed in 11 of 37 patients receiving nalidixic acid and in 2 of 26 patients infected with nalidixic acid-susceptible strains as against none in the group receiving pivmecillinam. The results suggest that pivmecillinam given orally was, in fact, more effective than nalidixic acid in the treatment of acute shigellosis in children, particularly when the resistant strains are taken into account.
在1-8岁儿童急性志贺菌病的治疗中，对口服匹美西林与萘啶酸的疗效进行了比较。在一项双盲试验中，我们研究了80名病程少于3天、有血性腹泻的可比儿童。71名儿童分离出志贺菌属。患者被随机分配接受口服匹美西林（50mg/kg·天）或萘啶酸（60mg/kg·天），均服用5天。两个治疗组的排便次数均逐渐减少。萘啶酸未能根除10例患者的志贺菌属，而匹美西林组为3例（p=0.04）。同样，接受萘啶酸治疗的37例患者中有11例出现临床失败，感染对萘啶酸敏感菌株的26例患者中有2例出现临床失败，而接受匹美西林治疗的组无一例出现临床失败。结果表明，口服匹美西林在治疗儿童急性志贺菌病方面实际上比萘啶酸更有效，尤其是考虑到耐药菌株时。
