Mhalu F S, Mmari P W, Ijumba J
Lancet. 1979 Feb 17;1(8112):345-7. doi: 10.1016/s0140-6736(79)92889-7.
110 El Tor Vibrio cholerae isolates from 102 patients with cholera between November, 1977, and March, 1978, during the early stages of the fourth epidemic of cholera in Tanzania had minimum inhibitory concentrations to tetracycline, chloramphenicol, nitrofurantoin, neomycin, ampicillin, and sulphadimidine determined. All isolates during the first month after the disease was recognised were fully sensitive to tetracycline, but 76% of isolates were resistant to the drug after five months of extensive use of tetracycline therapeutically and prophylactically in the country. Resistance to the five other antibacterial agents developed more slowly. Isolates from patients who failed to clear the organism from their stools or who had cholera soon after tetracycline prophylaxis had increased minimum inhibitory concentrations of the drug. Resistance did not develop in vivo. Although resistance to tetracycline readily developed following extensive use of the drug, such a resistance was not the only reason for failure of tetracycline treatment and prophylaxis. Mass chemoprophylaxis in the control of cholera should be discouraged unless evidence to the contrary becomes available.
对1977年11月至1978年3月坦桑尼亚第四次霍乱流行早期102例霍乱患者分离出的110株埃尔托霍乱弧菌，测定了其对四环素、氯霉素、呋喃妥因、新霉素、氨苄青霉素和磺胺二甲嘧啶的最低抑菌浓度。在疾病被确认后的第一个月，所有分离株对四环素均完全敏感，但在该国将四环素用于治疗和预防五个月后，76%的分离株对该药产生了耐药性。对其他五种抗菌药物的耐药性发展较为缓慢。粪便中未能清除该菌的患者或在四环素预防后不久患霍乱的患者所分离出的菌株，该药的最低抑菌浓度有所增加。耐药性并非在体内产生。尽管在广泛使用四环素后很容易产生对四环素的耐药性，但这种耐药性并非四环素治疗和预防失败的唯一原因。除非有相反的证据，否则应不鼓励在霍乱控制中进行大规模化学预防。
