FAILURE OF CEFTRIAXONE IN THE TREATMENT OF ACUTE BRUCELLOSIS
FAILURE OF CEFTRIAXONE IN THE TREATMENT OF ACUTE BRUCELLOSIS
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DOI：
10.1093/clinids/14.2.506
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发表时间：
1992-02-01
影响因子：
11.8
通讯作者：
RAZ, R
中科院分区：
文献类型：
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作者：
LANG, R;DAGAN, R;RAZ, R
1989年在以色列进行的一项开放的多中心研究中，18名急性布鲁氏菌病患者被随机分成两组，一组接受少于或等于2g的头孢曲松每日肌肉注射，持续至少两周；另一组接受多西环素加链霉素治疗两周。用多西环素和链霉素联合治疗的10例患者均迅速起效，在6个月的随访中感染均未复发。在接受头孢曲松治疗的8名患者中，有6名最初没有反应；当头孢曲松被多西环素和链霉素的组合取代时，患者立即有了反应。在随访期间，这些患者均未见感染复发。1例接受头孢曲松治疗的患者在6个月的随访结束时有反应并保持良好，1例最初接受该药物治疗的患者在3周内感染复发，但在开始使用多西环素/链霉素方案后恢复。我们的结论是，尽管体外研究和有希望的临床研究提供了令人鼓舞的数据，但每天肌注2g头孢曲松不应被认为是治疗布鲁氏菌病的合适方法。
In an open, multicenter study conducted in Israel in 1989, 18 patients with acute brucellosis were randomized to receive either less-than-or-equal-to 2 g of intramuscularly administered ceftriaxone daily for at least 2 weeks or doxycycline for 4 weeks plus streptomycin for 2 weeks. All 10 patients treated with the combination of doxycycline plus streptomycin responded promptly, and their infections did not relapse during 6 months of follow-up. Of eight patients treated with ceftriaxone, six did not respond initially; when ceftriaxone was replaced by the combination of doxycycline and streptomycin, patients responded immediately. No relapses of infection were observed in these patients during follow-up. One patient who received ceftriaxone responded and remained well at the end of 6 months of follow-up, and one patient who initially responded to therapy with this drug experienced relapse of infection within 3 weeks but recovered when the doxycycline/streptomycin regimen was initiated. We conclude that despite encouraging data from in vitro studies and promising clinical studies, 2 g of ceftriaxone administered im daily should not be considered appropriate therapy for brucellosis.