Persistence of salmonellae in blood and bone marrow: Randomized controlled trial comparing ciprofloxacin and chloramphenicol treatments against enteric fever
Persistence of salmonellae in blood and bone marrow: Randomized controlled trial comparing ciprofloxacin and chloramphenicol treatments against enteric fever
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DOI：
10.1128/aac.47.5.1727-1731.2003
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发表时间：
2003-05-01
影响因子：
4.9
通讯作者：
van der Meer, JWM
中科院分区：
文献类型：
--
作者：
Gasem, MH;Keuter, M;van der Meer, JWM
我们进行了一项随机对照试验，涉及55例成人肠热病患者，比较环丙沙星和氯霉素。在治疗期间进行血液和骨髓培养以及细胞因子谱，以比较这些药物的临床和细菌学疗效。所有患者被随机分配接受氯霉素（500 mg，每日4次，口服）14天或环丙沙星（500 mg，每日2次，口服）7天。在每个治疗组中，患者随后被随机分配到治疗3天或5天后进行血液和骨髓培养。27名患者接受氯霉素，28名接受环丙沙星。两组在基线特征方面相似。临床治愈率和退热时间无显著差异，所有分离菌株对两种抗生素均敏感。虽然环丙沙星是更有效地消除肠道沙门氏菌血清型伤寒和甲型副伤寒从骨髓比氯霉素，仍然有一个令人印象深刻的持久性沙门氏菌在骨髓培养（67%）。在环丙沙星治疗的患者中，受抑制的细胞因子产生能力显示出比氯霉素治疗的患者更早恢复正常的趋势。
We performed a randomized controlled trial involving 55 adult patients with enteric fever to compare ciprofloxacin and chloramphenicol. Blood and bone marrow cultures and cytokine profiles during therapy were done to compare the clinical and bacteriological efficacies of these drugs. All patients were randomly assigned to receive chloramphenicol (500 mg four times a day orally) for 14 days or ciprofloxacin (500 mg twice a day orally) for 7 days. In each treatment group, patients were subsequently randomized to have blood and bone marrow cultured after either 3 or 5 days of treatment. Twenty-seven patients received chloramphenicol, and 28 received ciprofloxacin. The two groups were similar in terms of baseline characteristics. No significant differences in clinical cure and time to defervescence were found. All strains isolated were susceptible to both antibiotics. Although ciprofloxacin was more effective in the elimination of Salmonella enterica serovars Typhi and Paratyphi A from bone marrow than chloramphenicol, there was still an impressive persistence of Salmonella in the bone marrow culture (67%). In the ciprofloxacin-treated patients the suppressed cytokine production capacity showed a trend to normalize earlier than in patients treated with chloramphenicol.