Carenfelt C, Eneroth C M, Lundberg C, Wretlind B
Scand J Infect Dis. 1975;7(4):259-64. doi: 10.3109/inf.1975.7.issue-4.07.
As the effect of antibiotic treatment of maxillary sinusitis has been questioned, the elimination of bacteria from sinus secretions was studied during antibiotic treatment. Penicillin V, azidocillin, tetracycline or doxycycline was administered to 54 patients with maxillary sinusitis. Samples of sinus secretion were aspirated both before treatment and 2-3 days after the onset of treatment. When the antibiotic concentration was below the upper limit of MIC for sensitivity group 1, bacterial growth was present in practically all samples. When the antibiotic concentration equalled or was above this limit, there was no bacterial growth in about half of the samples. A prerequisite for antibiotic effect--elimination of bacteria--is that the antibiotic concentration is well above the MIC of the bacteria at the site of infection. The choice between bactericidal or bacteriostatic antibiotics appeared unimportant. Bacterial survival in the maxillary sinus despite a high antibiotic concentration in the sinus illustrates that MIC values determined in the laboratory do not always mirror the sensitivity of bacteria to antibiotics in vivo.
由于上颌窦炎抗生素治疗的效果受到质疑，因此在抗生素治疗期间对鼻窦分泌物中的细菌清除情况进行了研究。对54例上颌窦炎患者使用了青霉素V、叠氮西林、四环素或强力霉素。在治疗前以及治疗开始后2 - 3天采集鼻窦分泌物样本。当抗生素浓度低于敏感组1的MIC上限时，几乎所有样本中都存在细菌生长。当抗生素浓度等于或高于此限时，约一半的样本中没有细菌生长。抗生素发挥作用（即清除细菌）的一个前提条件是抗生素浓度远高于感染部位细菌的MIC。杀菌性或抑菌性抗生素之间的选择似乎并不重要。尽管鼻窦中抗生素浓度很高，但上颌窦内仍有细菌存活，这说明实验室测定的MIC值并不总是能反映细菌在体内对抗生素的敏感性。
