Nouda H, Harabe E T, Sumita Y, Okuda T, Fukasawa M
Research Laboratories, Sumitomo Pharmaceuticals Co., Ltd., Osaka, Japan.
Chemotherapy. 1992;38(4):218-24. doi: 10.1159/000239004.
The affinity of meropenem for various known types of beta-lactamases and its stability to them were tested in comparison with other beta-lactams, including imipenem. Meropenem exhibited a marked stability to all beta-lactamases tested and was only hydrolyzed by Xanthomonas maltophilia beta-lactamase, as were other beta-lactams. This was responsible for the potent antibacterial activities of meropenem against beta-lactamase-producing strains. Meropenem and imipenem had almost the same, relatively high affinity for beta-lactamases; however, they had a lower affinity than clavulanic acid for penicillin beta-lactamases and cefoxitin for cephalosporin beta-lactamases. Meropenem also had higher beta-lactamase inhibitory activity than imipenem. Meropenem inhibited type III (TEM-1), Ia Citrobacter freundii and Ic Proteus vulgaris beta-lactamases in a progressive manner. Meropenem was thought to be a potent inhibitor of various beta-lactamase because of its ability to form stable enzyme-meropenem acyl-complexes. Meropenem generally exhibited a lower induction potential than imipenem against five clinical isolates of C. freundii, Enterobacter cloacae and Pseudomonas aeruginosa, but its induction potential was higher than that of ceftazidime. Meropenem induced beta-lactamases at concentrations above the MIC.
将美罗培南与其他β-内酰胺类抗生素(包括亚胺培南)进行比较,测试了美罗培南对各种已知类型β-内酰胺酶的亲和力及其对它们的稳定性。美罗培南对所有测试的β-内酰胺酶均表现出显著的稳定性,并且仅被嗜麦芽窄食单胞菌β-内酰胺酶水解,其他β-内酰胺类抗生素也是如此。这就是美罗培南对产β-内酰胺酶菌株具有强大抗菌活性的原因。美罗培南和亚胺培南对β-内酰胺酶的亲和力几乎相同,且相对较高;然而,它们对青霉素β-内酰胺酶的亲和力低于克拉维酸,对头孢菌素β-内酰胺酶的亲和力低于头孢西丁。美罗培南的β-内酰胺酶抑制活性也高于亚胺培南。美罗培南以渐进的方式抑制III型(TEM-1)、弗氏柠檬酸杆菌Ia型和普通变形杆菌Ic型β-内酰胺酶。由于美罗培南能够形成稳定的酶-美罗培南酰基复合物,因此被认为是一种有效的各种β-内酰胺酶抑制剂。对于弗氏柠檬酸杆菌、阴沟肠杆菌和铜绿假单胞菌的五株临床分离株,美罗培南的诱导潜力通常比亚胺培南低,但高于头孢他啶。美罗培南在高于最低抑菌浓度的浓度下可诱导β-内酰胺酶。