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Chloramphenicol 에 依한 腸티브스 治療經驗

Chemotherapeutic Effect of Chloramphenicol against Enteric Fevers Clinical Experience with 233 cases

대한의학협회지 1963년 6권 2호 p.159 ~ 162
李戰汶, 呂天基,
소속 상세정보
李戰汶 (  ) - 서울대학교 醫科大學 內科學敎室
呂天基 (  ) - 서울대학교 醫科大學 內科學敎室

Abstract


The authors treated with chloramphenicol as the chief chemotherapeutic agent 233 cases of typhoid and paratyphoid fevers which were admitted to the Seoul National University Hospital from Jung 1956 to December, 1962 (during a period of some six and half years)
Some of the clinical experiences thus obtained can be Summarized as follows:
1) Though the combined use of intermittent administration of chloramphenicol and intradermal injection oy typhoid vaccine once weekly during the afebrile period seems the best at present. We experienced in these two years at least 5 cases of relapse and 3 cases of chronic carrier state in patients treated in this way
So it can hardly be said an ideal and infallible method.
2) Of the three convalescent carriers culture of the bile obtained by Lyon´s technique was positive for Salmonella bacilli in one case and negative in the other two.
They (the 3 carriers) were freed from the carrier state after a 2~3 months period of combined intermittent chloramphenicol administration and vaccination.
3) The easy availability and consequent abuse of antibiotics may account for the higher incidence of intestinal hemorrhage and perforation, and also for the relatively high and perforathin, and also for the relatively high mortality rates in cases we treated.
It seems that the present state of Korea not only is inadequate for the eradication of enteric fevers, but on the contrary aids in the wider distribution of causative organisms.
4) In recent years the average length of time from the onset of the disease to the admission to hospitals became delayed after the wide use of antibiotics. Such tendency may be responsible for the lessened effect of chloramphenicol in this country.
5) In serious, toxic cases, and cases in which fever continued unexpectedly long without complications the combined use of chloramphenicol and steroid hormones ofter proved and excellent therapeutic regimen.

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