Limson B M
Makati Medical Center, Metro Manila, Philippines.
Drugs. 1995;49 Suppl 2:136-8. doi: 10.2165/00003495-199500492-00022.
A 14-day course of chloramphenicol or cotrimoxazole has been standard chemotherapy for uncomplicated salmonella enteric fever for several decades. The new fluoroquinolones show in vitro minimum inhibitory concentrations against Salmonella spp. ranging from 0.003 to 0.25 mg/L. Early clinical trials with 14-day courses of ciprofloxacin, ofloxacin or pefloxacin given orally achieved cure rates of 100%. Subsequent trials with 7- to 10-day courses of these fluoroquinolones also consistently yielded cure rates of 100%, whereas more recent trials of 3- to 6-day courses reported preliminary cure rates of 67 to 99%. At present, it appears that fluoroquinolone therapy for at least 7 days is a cost-effective substitute for the standard drugs in uncomplicated salmonella infections resistant to cotrimoxazole and/or chloramphenicol. The use of shorter 3- to 6-day courses of fluoroquinolone therapy needs further study, in view of lower cure rates reported in preliminary clinical trials.
几十年来，14天疗程的氯霉素或复方新诺明一直是无并发症的沙门氏菌肠热症的标准化疗方法。新型氟喹诺酮类药物对沙门氏菌属的体外最低抑菌浓度范围为0.003至0.25毫克/升。早期口服环丙沙星、氧氟沙星或培氟沙星14天疗程的临床试验治愈率达100%。随后对这些氟喹诺酮类药物7至10天疗程的试验也始终取得了100%的治愈率，而最近对3至6天疗程的试验报告的初步治愈率为67%至99%。目前，对于对复方新诺明和/或氯霉素耐药的无并发症沙门氏菌感染，至少7天的氟喹诺酮类药物治疗似乎是标准药物具有成本效益的替代方案。鉴于初步临床试验报告的治愈率较低，使用3至6天较短疗程的氟喹诺酮类药物治疗需要进一步研究。
