耐药株伤寒非常规治疗的探讨

An Approach of Nonroutine Treatment of Typhoid Fever Caused by Resistant Strains

采用常规药物治疗耐药菌株伤寒的疗效令人失望.61例用氯霉素治疗,34例以氨苄青霉素治疗.临床无效率氯霉素组为47.6％,氨苄青露素组为23.5％.23例采用庆大霉素治疗,其临床疗效显示缓慢。在由耐药菌株引起的伤寒之治疗中,研究了非常规药物的疗效:51例患者采用硫酸小诺霉素治疗,平均退热时问需9.66±3.03天,显效率仅10％.其它如磷霉素钠、丁胺卡那霉素、氟哌酸和氟嗪酸等亦各存在不足之处.作者认为,具有协同作用的抗菌药物的联合用药,是治疗多重耐药株伤寒的最佳方法.近4年来,选用氟哌酸联合丁胺卡那霉素治疗重症伤寒,疗效满意,使伤寒的病死率显著地降低.

The curative effect with routine drugs in therapy of typhoid fever caused by resistant strains was disappointed. Clinical ineffective rate were 47. 6% in 61 patients treated with chloramphenicol and 23. 5% in 34 patients treated with ampicillin. Twenty-three patients were treated with gentamycin, their clinical response was ap- peared slowly. We studied the effect of nonroutine drugs in the therapy of typhoid fever caused by resistant strains:51 patients were treated with micronomycin sulfas and the mean antipyretic times were 9. 66±3. 03d. Their marked effective rate was only 10%. All of the phosphonomycin natium, amikacin, norfloxacin and ofloxacin used done were not very effective. The author considered that combination of efficient antibiotics were optimum regimen in therapy of typhoid fever caused by multiresistant strains. Tha combination of norfloxacin with amikacin active in severe typhoid fever has yielded good results and decreased the mortality significantly in the past 4 years in our hospital.