Domenech A, Cabellos C, Ribes S, Tubau F, Viladrich P F, Liñares J, Gudiol F
Experimental Infection Laboratory, Infectious Diseases Service and Microbiology Service, Hospital Universitari de Bellvitge, Barcelona, Spain.
Microb Drug Resist. 2003;9 Suppl 1:S53-9. doi: 10.1089/107662903322541900.
The increasing incidence of ciprofloxacin resistance in Streptococcus pneumoniae may limit the efficacy of the new quinolones in difficult-to-treat infections such as meningitis. The aim of the present study was to determine the efficacy of clinafloxacin alone and in combination with teicoplanin and rifampin in the therapy of ciprofloxacin-susceptible and ciprofloxacin-resistant pneumococcal meningitis in rabbits. When used against a penicillin-resistant ciprofloxacin-susceptible strain (Clinafloxacin MIC 0.12 microg/ml), clinafloxacin at a dose of 20 mg/kg per day b.i.d. decreased bacterial concentration by -5.10 log cfu/ml at 24 hr. Combinations did not improve activity. The same clinafloxacin schedule against a penicillin- and ciprofloxacin-resistant strain (Clinafloxacin MIC 0.5 microg/ml) was totally ineffective. Our data suggest that a moderate decrease in quinolone susceptibility, as indicated by the detection of any degree of ciprofloxacin resistance, may render these antibiotics unsuitable for the management of pneumococcal meningitis.
肺炎链球菌对环丙沙星耐药性的日益增加可能会限制新型喹诺酮类药物在治疗如脑膜炎等难治性感染中的疗效。本研究的目的是确定克林沙星单独使用以及与替考拉宁和利福平联合使用对兔环丙沙星敏感和环丙沙星耐药的肺炎球菌性脑膜炎的治疗效果。当用于对抗青霉素耐药但环丙沙星敏感的菌株（克林沙星最低抑菌浓度为0.12微克/毫升）时，每日两次、剂量为20毫克/千克的克林沙星在24小时时使细菌浓度降低了-5.10 log cfu/毫升。联合用药并未提高疗效。针对青霉素和环丙沙星耐药的菌株（克林沙星最低抑菌浓度为0.5微克/毫升）采用相同的克林沙星给药方案则完全无效。我们的数据表明，如检测到任何程度的环丙沙星耐药所显示的喹诺酮敏感性的适度降低，可能会使这些抗生素不适用于肺炎球菌性脑膜炎的治疗。
