Use of trimethoprim-sulfamethoxazole for treatment of infections due to Nocardia.
Use of trimethoprim-sulfamethoxazole for treatment of infections due to Nocardia.
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甲氧苄氨嘧啶-磺胺甲恶唑用于治疗诺卡氏菌引起的感染的用途。
DOI：
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发表时间：
1982
期刊：
影响因子：
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通讯作者：
D. Hollowell
中科院分区：
文献类型：
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作者：
R. Wallace;E. Septimus;T. W. Williams;R. Conklin;T. Satterwhite;M. B. Bushby;D. Hollowell
本文报告用复方新诺明治疗34例肺部及皮肤诺卡氏菌病。在9例原发性皮肤病患者中，8例在短期治疗后感染迅速消退，随访6个月以上无复发。25例肺诺卡氏菌病患者有良好的临床反应，但5例完成不到3个月治疗的患者中有3例（60%）在4周内复发。在完成4至6个月治疗的10名患者中，只有1名（10%）复发，这种复发是由于耐药性。采用琼脂连续稀释法，59株诺卡氏菌对SMZ的MIC < 25 μ g/ml者占96%。低于20%的人对2.5微克/毫升的TMP敏感。TMP与SMZ之间的协同作用通常存在于TMP与SMZ的比例为1：5、1：1或5：1时，但在1：20的比例时不太常见。纸片药敏试验易于进行，并容易将敏感菌株与耐药菌株分离。TMP-SMZ对诺卡氏菌病的治疗非常有效，但它在临床上是否比单独使用磺酰胺更有效的问题仍然没有答案。
Trimethoprim-sulfamethoxazole (TMP-SMZ) was used for treatment of 34 patients with pulmonary or cutaneous nocardiosis. Of nine patients with primary cutaneous disease, eight had rapid resolution of their infection after short-term therapy and none have relapsed after a follow-up of more than six months. The 25 patients with pulmonary nocardiosis had a good clinical response, but three of five (60%) who completed less than three months of therapy relapsed within four weeks. Of the 10 patients who completed four to six months of therapy, only one (10%) relapsed and this relapse was due to drug resistance. By the method of serial dilution in agar, 96% of 59 isolates of Nocardia had MICs of SMZ of less than 25 micrograms/ml. Fewer than 20% were susceptible to 2.5 micrograms of TMP/ml. Synergy between TMP and SMZ was usually present with ratios of TMP to SMZ of 1:5, 1:1, or 5:1, but was less common at a ratio of 1:20. Disk susceptibility testing was easy to perform and readily separated sensitive from resistant strains. TMP-SMZ is highly effective for the treatment of nocardiosis, but the question of whether it is more effective clinically than a sulfonamide alone remains unanswered.