Williams J D, Maskell J P, Shain H, Chrysos G, Sefton A M, Fraser H Y, Hardie J M
Department of Medical Microbiology, London Hospital Medical College, UK.
J Antimicrob Chemother. 1992 Jul;30(1):27-37. doi: 10.1093/jac/30.1.27.
The in-vitro activities of azithromycin, clarithromycin, spiramycin and RP 59500 were compared with erythromycin against a wide range of oral organisms which have been implicated in oral infections and/or endocarditis (clindamycin was included for oral streptococci). All compounds tested showed good activity against many of these organisms, although some variation was observed with different species. Clarithromycin was the most active of the antibiotics tested against Gram-positive anaerobes, including Actinomyces spp., Propionibacterium spp., Lactobacillus spp. and Bifidobacterium dentium. Azithromycin was slightly less active than erythromycin against these species. In general, RP 59500 had higher MICs than the macrolides, other than spiramycin, against these organisms, but was superior in activity against Peptostreptococcus spp., inhibiting all isolates at 2 mg/L. Azithromycin was, in general, the most active antibiotic tested against the Gram-negative anaerobes: Fusobacterium spp., Bacteroides spp., Wolinella spp., Actinobacillus actinomycetemcomitans, Selenomonas spp. and Mitsuokella multiacida, including those isolates which were insusceptible to erythromycin. Clarithromycin showed similar activity to erythromycin against most Gram-negative species, but was superior against Capnocytophaga ochraceus and Eikenella corrodens. RP 59500 was less active than the macrolides against most Gram-negative anaerobes, but was superior to erythromycin and clarithromycin against Fusobacterium spp. and Leptotrichia buccalis, some strains of which were moderately resistant to erythromycin. The macrolides and clindamycin were about equally active against the oral streptococci, whereas RP 59500 showed lower inhibitory activity. The in-vitro results suggest that azithromycin and clarithromycin may be of value in the treatment of dental sepsis and the prophylaxis of endocarditis. RP 59500 showed useful activity against Gram-positive anaerobes and, because of its bactericidal activity against oral streptococci, may also prove to have a role in these areas.
将阿奇霉素、克拉霉素、螺旋霉素和RP 59500的体外活性与红霉素针对多种与口腔感染和/或心内膜炎有关的口腔微生物进行了比较（针对口腔链球菌纳入了克林霉素）。所有测试的化合物对许多这些微生物均显示出良好活性，不过不同菌种之间存在一些差异。克拉霉素是测试的抗生素中对革兰氏阳性厌氧菌（包括放线菌属、丙酸杆菌属、乳酸杆菌属和龋齿双歧杆菌）活性最强的。阿奇霉素对这些菌种的活性略低于红霉素。总体而言，除螺旋霉素外，RP 59500对这些微生物的最低抑菌浓度（MIC）高于大环内酯类抗生素，但对消化链球菌属的活性更强，在2mg/L时可抑制所有分离株。总体而言，阿奇霉素是测试的抗生素中对革兰氏阴性厌氧菌（具核梭杆菌属、拟杆菌属、沃廉菌属、伴放线放线杆菌、月形单胞菌属和多酸 Mitsuokella菌）活性最强的，包括那些对红霉素不敏感的分离株。克拉霉素对大多数革兰氏阴性菌种的活性与红霉素相似，但对微黄二氧化碳嗜纤维菌和腐蚀艾肯菌的活性更强。RP 59500对大多数革兰氏阴性厌氧菌的活性低于大环内酯类抗生素，但对具核梭杆菌属和颊纤毛菌的活性优于红霉素和克拉霉素，其中一些菌株对红霉素呈中度耐药。大环内酯类抗生素和克林霉素对口腔链球菌的活性大致相同，而RP 59500的抑制活性较低。体外研究结果表明，阿奇霉素和克拉霉素在治疗牙源性败血症和预防心内膜炎方面可能具有价值。RP 59500对革兰氏阳性厌氧菌显示出有效活性，并且由于其对口腔链球菌具有杀菌活性，在这些领域也可能证明有一定作用。
