Domenico P, Hopkins T, Schoch P E, Cunha B A
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501.
J Antimicrob Chemother. 1990 Jun;25(6):903-14. doi: 10.1093/jac/25.6.903.
This study determined the effects of sodium salicylate combined with several aminoglycoside antibiotics on the growth and capsular polysaccharide (CPS) production of Klebsiella pneumoniae. Salicylate significantly enhanced in inhibitory effect of all aminoglycoside antibiotics against all bacterial strains tested. The production of CPS was decreased by 62-86% when 2.5 mM salicylate was used. Amikacin combined with salicylate reduced CPS only slightly more than salicylate alone. The chelating agents, ethylenediamine tetra-acetic acid and ethylene bis tetraacetic acid, which have similar CPS-reducing properties, did not enhance the inhibitory effect of amikacin. Noncapsular variants of strains of K. pneumoniae were as susceptible to amikacin as the fully encapsulated strains, with or without salicylate present. Therefore, the combination of salicylate and the aminoglycosides acted synergistically to inhibit K. pneumoniae growth, but the increase in antibiotic sensitivity with salicylate was not a result of a reduction in CPS production. The use of salicylate in maximum therapeutic doses may enhance the activity of aminoglycosides sufficiently to allow the dose of aminoglycoside to be reduced when infections due to K. pneumoniae are treated.
本研究确定了水杨酸钠与几种氨基糖苷类抗生素联合使用对肺炎克雷伯菌生长及荚膜多糖（CPS）产生的影响。水杨酸盐显著增强了所有氨基糖苷类抗生素对所有测试菌株的抑制作用。当使用2.5 mM水杨酸盐时，CPS的产生减少了62%至86%。阿米卡星与水杨酸盐联合使用时对CPS的减少仅比单独使用水杨酸盐略多。具有相似CPS减少特性的螯合剂乙二胺四乙酸和亚乙基双四乙酸，并未增强阿米卡星的抑制作用。无论有无水杨酸盐存在，肺炎克雷伯菌菌株的非荚膜变体对阿米卡星的敏感性与完全荚膜化菌株相同。因此，水杨酸盐和氨基糖苷类联合使用具有协同作用来抑制肺炎克雷伯菌的生长，但水杨酸盐使抗生素敏感性增加并非CPS产生减少的结果。在治疗肺炎克雷伯菌感染时，使用最大治疗剂量的水杨酸盐可能会充分增强氨基糖苷类的活性，从而允许减少氨基糖苷类的剂量。
