Rotimi V O, Mokaddas E M, Jamal W Y, Khodakhast F B, Verghese T L, Sanyal S C
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat.
J Chemother. 1999 Oct;11(5):349-56. doi: 10.1179/joc.1999.11.5.349.
Trovafloxacin is a novel investigational trifluoronaphthyridone antibiotic with broad-spectrum activity against Gram-positive and Gram-negative organisms. Its in-vitro activity and those of eight other antimicrobial agents were evaluated against 497 clinical isolates of Gram-negative anaerobic bacteria by the agar dilution method. Trovafloxacin had excellent activity, with a minimum inhibitory concentration (MIC) range of <0.03-4 microg/ml, against all species. Out of the 497 isolates tested, 496 (99.5%) were inhibited by a concentration of < or = 2.0 microg/ml of trovafloxacin; the remaining two strains were inhibited by a concentration of 4.0 microg/ml. The MIC50s and MIC90s were 0.12 microg/ml and 1.0 microg/ml, respectively. Meropenem, imipenem and piperacillin/tazobactam were also very active. Overall, at the MIC90s, trovafloxacin was as active as meropenem, slightly more active than metronidazole and imipenem, twice as active as amoxicillin-clavulanic acid, five times more active than piperacillintazobactam and 68 times more active than clindamycin. About 21% of the isolates were resistant to cefoxitin, 30% to clindamycin and 40% to piperacillin. Five species in the Bacteroides fragilis group of isolates were highly resistant to metronidazole (MIC >128 microg/ml). In general, the relatively more resistant species were the B. vulgatus, B. ovatus, B. thetaiotaomicron, and B. fragilis sensu stricto, in that order. All the isolates of the B. fragilis group and about 50% of the Prevotella spp. were beta-lactamase positive. Trovafloxacin certainly holds promise as an alternative drug for therapy of anaerobic infections.
曲伐沙星是一种新型的三氟萘啶酮类抗生素，正在进行研究，对革兰氏阳性菌和革兰氏阴性菌具有广谱活性。采用琼脂稀释法，对497株革兰氏阴性厌氧菌临床分离株评估了曲伐沙星及其他8种抗菌药物的体外活性。曲伐沙星对所有菌种均具有优异活性，最低抑菌浓度（MIC）范围为<0.03 - 4微克/毫升。在497株受试分离株中，496株（99.5%）被浓度≤2.0微克/毫升的曲伐沙星抑制；其余两株被4.0微克/毫升的浓度抑制。MIC50和MIC90分别为0.12微克/毫升和1.0微克/毫升。美罗培南、亚胺培南和哌拉西林/他唑巴坦也具有很强的活性。总体而言，在MIC90时，曲伐沙星与美罗培南活性相当，比甲硝唑和亚胺培南稍强，是阿莫西林-克拉维酸活性的两倍，哌拉西林-他唑巴坦活性的五倍，克林霉素活性的68倍。约21%的分离株对头孢西丁耐药，30%对克林霉素耐药，40%对哌拉西林耐药。脆弱拟杆菌群中的5个菌种对甲硝唑高度耐药（MIC>128微克/毫升）。一般来说，耐药性相对较强的菌种依次为普通拟杆菌、卵形拟杆菌、多形拟杆菌和严格意义上的脆弱拟杆菌。所有脆弱拟杆菌群分离株和约50%的普雷沃菌属菌株β-内酰胺酶呈阳性。曲伐沙星无疑有望成为治疗厌氧菌感染的替代药物。
