Chan G P, Garcia-Ignacio B Y, Chavez V E, Livelo J B, Jimenez C L, Parrilla M L, Franzblau S G
Research Institute for Tropical Medicine, Muntinlupa, Metro Manila, Philippines.
Antimicrob Agents Chemother. 1994 Mar;38(3):515-7. doi: 10.1128/AAC.38.3.515.
Clarithromycin was administered to nine previously untreated lepromatous leprosy patients. Patients received two 1,500-mg doses on the first day, followed by 7 days of no treatment, in order to evaluate the potential efficacy of intermittent therapy. Patients then received 1,000 mg daily for 2 weeks followed by 500 mg daily for 9 weeks. The efficacy of therapy was monitored clinically, by changes in morphological index, mouse footpad infectivity, and radiorespirometric activity of Mycobacterium leprae obtained from serial biopsies and by serum levels of phenolic glycolipid I. Clarithromycin was well tolerated, with only minor side effects noted in two patients. Most patients showed reductions in morphological index and radiorespirometry 1 week after the first two doses. Within 3 weeks of starting treatment (total of 17 g of clarithromycin), biopsy-derived M. leprae specimens from all patients had a morphological index of zero, were noninfectious for mice, and had less than 1% of the radiorespirometric activity of pretreatment specimens. Reductions in serum phenolic glycolipid I levels were observed for most patients at 3 weeks. Significant clinical improvement was evident after 4 weeks of treatment. All analyses indicate that clarithromycin is rapidly bactericidal for M. leprae in humans.
对9名未经治疗的瘤型麻风患者给予克拉霉素。患者在第一天接受两剂1500毫克的药物，随后7天不进行治疗，以评估间歇疗法的潜在疗效。然后患者每天接受1000毫克治疗2周，之后每天接受500毫克治疗9周。通过临床监测、形态学指数变化、小鼠足垫感染性以及从连续活检获得的麻风分枝杆菌的放射性呼吸测定活性变化，以及血清中酚糖脂I水平来监测治疗效果。克拉霉素耐受性良好，仅两名患者出现轻微副作用。大多数患者在前两剂给药后1周形态学指数和放射性呼吸测定值降低。在开始治疗的3周内（总共使用17克克拉霉素），所有患者活检获得的麻风分枝杆菌标本形态学指数为零，对小鼠无感染性，放射性呼吸测定活性低于治疗前标本的1%。大多数患者在3周时血清酚糖脂I水平降低。治疗4周后临床有明显改善。所有分析表明，克拉霉素对人体中的麻风分枝杆菌具有快速杀菌作用。
