Bethell D B, Hien T T, Phi L T, Day N P, Vinh H, Duong N M, Len N V, Chuong L V, White N J
Centre for Tropical Diseases, Ho Chi Minh City, Viet Nam.
Arch Dis Child. 1996 Jan;74(1):44-6. doi: 10.1136/adc.74.1.44.
The aim of the study was to document the effects of short courses of fluoroquinolones given during an outbreak of multidrug resistant typhoid fever in southern Viet Nam on the growth of children over a period of two years. In a prospective cohort study, 326 Vietnamese children aged between 1 and 14 years were followed up for two years after receiving either ciprofloxacin (70 mg/kg given over 7 d) (n = 173) or ofloxacin (45-50 mg/kg given over 3-5 d) (n = 153) for suspected typhoid fever. Growth velocity and weight for height were compared with an age matched control group of children from the same locality (n = 223) who had not contracted typhoid or received any fluoroquinolones. In the ofloxacin and ciprofloxacin treated patients there was no evidence of acute joint toxicity, nor of any joint symptoms attributable to either of the fluoroquinolones. There was no difference in expected weight for height measurements between the three groups of children over the two year period. During the first year, height velocity in ciprofloxacin treated children was greater than in either ofloxacin treated children or untreated controls. Height velocity in the latter two groups was not significantly different. After two years height velocity was similar in the three groups. The results support the use of short course fluoroquinolone treatment in childhood typhoid, especially when caused by strains resistant to other antibiotics.
该研究的目的是记录在越南南部多重耐药伤寒热暴发期间给予儿童短期氟喹诺酮类药物治疗对其两年内生长发育的影响。在一项前瞻性队列研究中,326名年龄在1至14岁之间的越南儿童因疑似伤寒热接受环丙沙星(70mg/kg,分7天给药)(n = 173)或氧氟沙星(45 - 50mg/kg,分3 - 5天给药)(n = 153)治疗后,随访两年。将生长速度和身高体重与来自同一地区未患伤寒或未接受任何氟喹诺酮类药物治疗的年龄匹配儿童对照组(n = 223)进行比较。在接受氧氟沙星和环丙沙星治疗的患者中,没有证据表明存在急性关节毒性,也没有任何可归因于这两种氟喹诺酮类药物的关节症状。在两年期间,三组儿童的预期身高体重测量值没有差异。在第一年,接受环丙沙星治疗的儿童身高增长速度高于接受氧氟沙星治疗的儿童或未治疗的对照组。后两组的身高增长速度没有显著差异。两年后,三组的身高增长速度相似。这些结果支持在儿童伤寒治疗中使用短期氟喹诺酮类药物治疗,尤其是由对其他抗生素耐药的菌株引起的伤寒。