Kumar A S, Legori M, Sathy N, Mathew R
Department of Pediatrics, Medical College, Thiruvananthapuram.
Indian Pediatr. 1995 May;32(5):533-8.
Treatment of typhoid fever with furazolidone produces a high cure rate. This is a clinical curiosity, as furazolidone is described to be poorly absorbed. The present study examined whether furazolidone could produce unequivocal clinical response and, if so whether this was due to the drug producing bactericidal levels in the serum. Twenty one patients selected by defined criteria were treated with furazolidone and evaluated for definite clinical response in 5-7 days. Bactericidal activity of pre dose and post dose sera were estimated in seven patients showing definite clinical response. All the seven patients had a clinical cure without the drug producing significant bactericidal levels in the blood. Hence we concluded that the major site of action of furazolidone was in the intestine. It is our postulate that the organisms reaching the intestine in large numbers from bile are prevented from gaining re-entry into the circulation by the action of furazolidone in the intestine. After repeated cycles of entry of organisms into the intestine from bile and the simultaneous prevention of its re-entry into the circulation, the number of organisms remaining in circulation comes down considerably, thus helping the immune system to bring about a cure.
用呋喃唑酮治疗伤寒热可产生较高的治愈率。这是一个临床奇闻，因为呋喃唑酮被描述为吸收较差。本研究检验了呋喃唑酮是否能产生明确的临床反应，如果是，这是否是由于药物在血清中产生杀菌水平所致。按照明确标准选择的21例患者接受了呋喃唑酮治疗，并在5至7天内评估明确的临床反应。对7例显示明确临床反应的患者测定了给药前和给药后血清的杀菌活性。所有7例患者均临床治愈，且药物在血液中未产生显著的杀菌水平。因此我们得出结论，呋喃唑酮的主要作用部位在肠道。我们推测，从胆汁大量进入肠道的病原体被肠道中呋喃唑酮的作用阻止再次进入循环。在病原体从胆汁反复进入肠道并同时被阻止再次进入循环的循环过程后，循环中残留的病原体数量大幅下降，从而有助于免疫系统实现治愈。
