Anderson J D, Adams M A, Barrington J C, Spence W N, Sheperd C A
Antimicrob Agents Chemother. 1976 Dec;10(6):872-7. doi: 10.1128/AAC.10.6.872.
Mecillinam is a new type of beta-lactam antibiotic (an amidinopenicillanic acid) that is particularly active against Enterobacteriaceae and is taken orally as in the form of an ester, pivmecillinam. Assessment of any new antibiotic should include a survey of levels of bacterial resistance and investigation of its capacity to select resistant organisms or harm the commensal flora. Antibiotic resistance patterns of 2,000 Enterobacteriaceae isolated from the urine of patients with significant urinary tract infections were therefore determined. Mecillinam-resistant Enterobacteriaceae were found to be much less common than ampicillin-amoxycillin-resistant organisms both in the community and in hospital patients. Most ampicillin-resistant Enterobacteriaceae from infected urines were susceptible to mecillinam, but the relatively rare mecillinam-resistant organisms were usually resistant to ampicillin and cephaloridine. The fecal flora of 26 healthy volunteers who served as controls or were given repeated courses of therapeutic doses of either ampicillin or pivmecillinam was studied. Pivmecillinam had only a transient effect on the aerobic fecal flora and in contrast to ampicillin did not increase populations of resistant Enterobacteriaceae, which would be a potential hazard to the patient and contaminate the environment.
美西林是一种新型β-内酰胺抗生素（一种脒基青霉素酸），对肠杆菌科细菌具有特别的活性，以酯（匹美西林）的形式口服。对任何一种新抗生素的评估都应包括对细菌耐药水平的调查以及对其选择耐药菌或损害共生菌群能力的研究。因此，我们测定了从患有严重尿路感染患者尿液中分离出的2000株肠杆菌科细菌的抗生素耐药模式。结果发现，无论是在社区患者还是医院患者中，耐美西林的肠杆菌科细菌都比耐氨苄西林-阿莫西林的细菌少见得多。大多数来自感染尿液的耐氨苄西林肠杆菌科细菌对美西林敏感，但相对罕见的耐美西林细菌通常对氨苄西林和头孢菌素耐药。我们研究了26名健康志愿者的粪便菌群，这些志愿者作为对照，或者接受了重复疗程的治疗剂量的氨苄西林或匹美西林。匹美西林对需氧粪便菌群只有短暂的影响，与氨苄西林不同，它不会增加耐药肠杆菌科细菌的数量，而这对患者可能是一种潜在危害，并污染环境。
