小児コレラに対するシングル用量シプロフロキサシンと12用量のエリトロミシン:ランダム化制御試験
Debasish Saha1, Wasif A Khan, Mohammad M Karim
1ICDDR, B, Centre for Health and Population Research, Dhaka, Bangladesh. dsaha@icddrb.org
Lancet (London, England)
|September 27, 2005
まとめ
シプロフロクサシンの単回投与は,エリトロミシンと比較して,重度の小児コレラに類似した臨床治癒率を提供します. しかし,シプロフロクサシンは,便のサンプルからビブリオコレラ菌を根絶する効果が低い.
科学分野:
- 小児の感染症について
- 抗菌剤療法とは,抗菌剤による治療である.
- 胃腸内科 胃腸内科
背景:
- 子どもにおける重度のコレラには,効果的な治療が必要です.
- シプロフロキサシンは,コレラ治療の潜在的な単回投与オプションです.
研究 の 目的:
- 子どもにおける重度のコレラの治療における単回投与シプロフロクサシンと複数回投与エリトロミシンの有効性を比較する.
- 臨床的治癒率とバクテリアの根絶を評価する.
主な方法:
- 重度のコレラを患った2歳から15歳の子どもを対象としたランダム化,オープンラベル試験.
- 参加者は,1回投与のシプロフロクサシンまたは3日間にわたって12回のエリトロマイシン投与を受けた.
- 臨床的成功は,48時間以内に水性便の停止として定義されました.
主要な成果:
- 臨床的成功率は類似しており,シプロフロクサシンでは60%,エリスロミシンでは55%でした.
- シプロフロキサシングループは,嘔吐が少なく,便が少なく,便の量も減少した.
- 細菌学的失敗は,エリトロマイシン (30%) と比較してシプロフロクサシン (58%) で有意に高かった.
結論:
- シプロフロクサシンの単一投与は,小児コレラに対する複数の用量のエリトロミシンと同様の臨床結果をもたらします.
- エリトロマイシンは,Vibrio choleraeを根絶する上で優れた有効性を示しました.
- シプロフロクサシンの使用を最適化したり,バクテリアクリアランスの代替案を探索するためにさらなる研究が必要になる可能性があります.
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