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本文报告血培养阳性的伤寒患者8例和副伤寒甲患者1例,用一种新的青霉素类抗菌素—甲亚胺青霉素(Mecillinam)(6-β-青霉酸脒)治疗的效果。8例伤寒患者因病情严重而作肌注或静注,当临床显效时则改用口服剂吡呋甲亚胺青霉素(Pivmecillinam),后者吸收后水解而成甲亚胺青霉素。除1例成人每次用600毫克,2例8岁患儿每次用200毫克外,其余均用400毫克,每6小时一次,疗程14天。至少6次标本培养阴性方可出院。甲亚胺青霉素对伤寒和副伤寒杆菌的最小抑菌浓度为0.03～0.5毫克/升,肌注或静注600毫克后,其血清浓度在4小时内可达最小抑菌浓度的10倍以上。 7例疗效满意,出院前6次大、小便培养阴性。开始治疗48小时后症状缓解,以后康复,无并发症。
This article reports the efficacy of a new penicillin-resistant antibiotic, mecillinam (6-β-penicillin), in 8 blood-positive typhoid fever and 1 paratyphoid fever patient. Eight patients with typhoid fever due to serious illness for intramuscular or intravenous injection, when clinically effective when the switch to oral flufenamicin penicillin (Pivmecillinam), the latter after hydrolysis hydrolyzate formazan penicillin. In addition to 1 adult each with 600 mg, 2 cases of 8-year-old children each with 200 mg, the remaining 400 mg, once every 6 hours, treatment of 14 days. At least 6 specimens negative culture before discharge. Methicillin penicillin typhoid and paratyphoid bacilli minimum inhibitory concentration of 0.03 to 0.5 mg / l, intramuscular or intravenous injection of 600 mg, the serum concentration within 4 hours up to 10 times the minimum inhibitory concentration. Seven cases were satisfactory, 6 times before discharge, urinary culture negative. 48 hours after treatment began to relieve symptoms, after recovery, no complications.