Wang F D, Liu I M, Liu C Y
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1999 Apr;62(4):230-5.
New macrolides with improved pharmacokinetic characteristics have been developed and introduced for clinical use in Taiwan. In order to understand the antibacterial activities of these new macrolides, we tested their in vitro activities against common pathogenic bacteria.
Minimum inhibitory concentrations (MICs) of azithromycin, clarithromycin, dirithromycin, erythromycin and roxithromycin for clinical isolates collected from six teaching hospitals in Taiwan were determined by the agar dilution method. The tested bacteria included methicillin-sensitive and -resistant coagulase-negative staphylococci, methicillin-sensitive and -resistant Staphylococcus aureus, viridans streptococci, Streptococcus pneumoniae, Streptococcus pyogenes, Enterococcus spp, Corynebacterium spp, Haemophilus influenzae, Moraxella catarrhalis and Bacteroides fragilis.
High MICs were detected against most of the bacteria tested except for H influenzae and M catarrhalis. The MIC90 for viridans streptococci, S pneumoniae, S pyogenes, Enterococcus spp, S aureus (both methicillin-sensitive and -resistant), coagulase-negative staphylococci (both methicillin-sensitive and -resistant), Coryne-bacterium spp, and B fragilis were all at least 128 micrograms/ml. Wide ranges of MICs were demonstrated.
Most bacteria tested were highly resistant to macrolides. This result is a warning for clinicians that rational use of antibiotics, including macrolides, is mandatory.
具有改善药代动力学特性的新型大环内酯类药物已被研发并引入台湾临床使用。为了解这些新型大环内酯类药物的抗菌活性,我们测试了它们对常见病原菌的体外活性。
采用琼脂稀释法测定阿奇霉素、克拉霉素、地红霉素、红霉素和罗红霉素对从台湾六家教学医院收集的临床分离株的最低抑菌浓度(MIC)。测试的细菌包括甲氧西林敏感和耐药的凝固酶阴性葡萄球菌、甲氧西林敏感和耐药的金黄色葡萄球菌、草绿色链球菌、肺炎链球菌、化脓性链球菌、肠球菌属、棒状杆菌属、流感嗜血杆菌、卡他莫拉菌和脆弱拟杆菌。
除流感嗜血杆菌和卡他莫拉菌外,对大多数测试细菌检测到高MIC。草绿色链球菌、肺炎链球菌、化脓性链球菌、肠球菌属、金黄色葡萄球菌(甲氧西林敏感和耐药)、凝固酶阴性葡萄球菌(甲氧西林敏感和耐药)、棒状杆菌属和脆弱拟杆菌的MIC90均至少为128微克/毫升。显示出广泛的MIC范围。
大多数测试细菌对大环内酯类药物高度耐药。这一结果警示临床医生,包括大环内酯类药物在内的抗生素合理使用是必要的。