Etesse-Carsenti H, Caillon J, Mondain V, Durant J, Bernard E, Dellamonica P, Drugeon H B
Service des Maladies Infectieuses, Hôpital de l'Archet, Nice, France.
Pathol Biol (Paris). 1991 Sep;39(7):658-67.
Betalactamase-producing organisms are responsible for an increasing number of ENT and lower respiratory tract infections. Or cephalosporins and the combination of amoxicillin with the beta-lactamase inhibitor clavulanic acid are alternatives to ampicillin therapy. The killing activity of cefadroxil on the organisms most often responsible for ENT and respiratory infections was evaluated in vitro using a viable bacteria count method, comparatively with cefaclor, josamycin, and amoxicillin-clavulanic acid. Killing activity was found to be time-dependent for all the antimicrobial agents studied. Cefadroxil exhibited the same bactericidal effect on Streptococcus pyogenes and S. pneumoniae than the other agents. Haemophilus influenzae and an increasing number of Pneumococcus strains were resistant to josamycin which is therefore not appropriate for first-line therapy. As compared with amoxicillin and amoxicillin-clavulanic acid, cefadroxil was less active on H. influenzae and more active on Staphylococcus aureus. Production of beta-lactamase failed to influence the killing activity of cefadroxil. These bacteriologic data, together with results of pharmacologic studies (long half-life and good penetration within tissues) can explain the clinical successes obtained with cefadroxil in ENT and lower respiratory tract infections.
产β-内酰胺酶的微生物导致耳鼻喉科和下呼吸道感染的病例日益增多。头孢菌素以及阿莫西林与β-内酰胺酶抑制剂克拉维酸的组合是氨苄西林治疗的替代方案。使用活菌计数法在体外评估了头孢羟氨苄对最常引起耳鼻喉科和呼吸道感染的微生物的杀灭活性,并与头孢克洛、交沙霉素和阿莫西林-克拉维酸进行了比较。发现所有研究的抗菌药物的杀灭活性均呈时间依赖性。头孢羟氨苄对化脓性链球菌和肺炎链球菌的杀菌效果与其他药物相同。流感嗜血杆菌和越来越多的肺炎球菌菌株对交沙霉素耐药,因此交沙霉素不适用于一线治疗。与阿莫西林和阿莫西林-克拉维酸相比,头孢羟氨苄对流感嗜血杆菌的活性较低,对金黄色葡萄球菌的活性较高。β-内酰胺酶的产生并未影响头孢羟氨苄的杀灭活性。这些细菌学数据,连同药理学研究结果(半衰期长和在组织内良好的渗透性)可以解释头孢羟氨苄在耳鼻喉科和下呼吸道感染中取得的临床成功。