Boswell F J, Andrews J M, Jevons G, Wise R
Department of Microbiology, City Hospital NHS Trust, Birmingham B18 7QH, UK.
J Antimicrob Chemother. 2002 Oct;50(4):495-502. doi: 10.1093/jac/dkf152.
In this study the in vitro activities and pharmacodynamic properties of moxifloxacin, levofloxacin, gatifloxacin and gemifloxacin were compared on recently isolated respiratory pathogens and strains of Streptococcus pneumoniae with known mechanisms of fluoroquinolone resistance. In addition, the resistance selection frequencies of moxifloxacin and levofloxacin on three recently isolated respiratory pathogens and four strains of S. pneumoniae with known mechanisms of fluoroquinolone resistance were investigated. The four fluoroquinolones had similar activities against both Moraxella catarrhalis (MIC(90)s 0.015-0.06 mg/L) and Haemophilus influenzae (MIC(90)s 0.008-0.03 mg/L). More marked differences in activity were noted with S. pneumoniae, with MIC(90)s of 0.25, 1, 0.5 and 0.03 mg/L for moxifloxacin, levofloxacin, gatifloxacin and gemifloxacin, respectively. With the S. pneumoniae strains, the four fluoroquinolones exhibited similar concentration-dependent time-kill kinetics. The resistance selection frequencies of levofloxacin were higher than those of moxifloxacin at concentrations equivalent to those at the end of the dosing interval. Therefore moxifloxacin may have less of an impact on the development of resistance than levofloxacin.
在本研究中，比较了莫西沙星、左氧氟沙星、加替沙星和吉米沙星对近期分离出的呼吸道病原体以及具有已知氟喹诺酮耐药机制的肺炎链球菌菌株的体外活性和药效学特性。此外，还研究了莫西沙星和左氧氟沙星对三种近期分离出的呼吸道病原体以及四种具有已知氟喹诺酮耐药机制的肺炎链球菌菌株的耐药选择频率。这四种氟喹诺酮类药物对卡他莫拉菌（MIC90为0.015 - 0.06mg/L）和流感嗜血杆菌（MIC90为0.008 - 0.03mg/L）的活性相似。在肺炎链球菌中观察到更明显的活性差异，莫西沙星、左氧氟沙星、加替沙星和吉米沙星的MIC90分别为0.25、1、0.5和0.03mg/L。对于肺炎链球菌菌株，这四种氟喹诺酮类药物表现出相似的浓度依赖性杀菌动力学。在相当于给药间隔末期的浓度下，左氧氟沙星的耐药选择频率高于莫西沙星。因此，与左氧氟沙星相比，莫西沙星对耐药性发展的影响可能较小。
