Domenico P, Hopkins T, Cunha B A
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501.
J Antimicrob Chemother. 1990 Sep;26(3):343-51. doi: 10.1093/jac/26.3.343.
Sodium salicylate was combined with the antibiotics amikacin, aztreonam, cefazolin, cefonicid, cefoperazone, ceftizoxime, norfloxacin, doxycycline, clindamycin, imipenem, mezlocillin and trimethoprim-sulphamethoxazole. The activity of the combinations was tested against encapsulated strains of Klebsiella pneumoniae, which differed markedly in their antibiotic susceptibility. The addition of salicylate (from 2 to 350 mg/l) to cultures increased the MIC of most antimicrobial agents from two- to four-fold, with the exception of imipenem and amikacin. Inhibition by imipenem was largely unchanged, and that of amikacin was increased in the presence of salicylate. The synergy of the combination of cefazolin and amikacin was abolished by salicylate, while the synergistic activity of imipenem and amikacin was significantly increased by salicylate. Doxycycline activity was most severely affected by salicylate as antimicrobial activity was significantly diminished at salicylate levels as low as 5 mg/l. In contrast, significant loss of inhibitory activity with other antimicrobials required at least 100 mg/l of salicylate. The clinical implications of salicylate on the sensitivity of K. pneumoniae to antimicrobials are discussed.
将水杨酸钠与抗生素阿米卡星、氨曲南、头孢唑林、头孢尼西、头孢哌酮、头孢唑肟、诺氟沙星、多西环素、克林霉素、亚胺培南、美洛西林和甲氧苄啶-磺胺甲恶唑联合使用。测试了这些联合用药对肺炎克雷伯菌包膜菌株的活性，这些菌株的抗生素敏感性差异显著。向培养物中添加水杨酸盐（2至350毫克/升）会使大多数抗菌剂的最低抑菌浓度（MIC）提高两到四倍，但亚胺培南和阿米卡星除外。亚胺培南的抑制作用基本不变，而在水杨酸盐存在的情况下，阿米卡星的抑制作用增强。水杨酸盐消除了头孢唑林和阿米卡星联合用药的协同作用，而水杨酸盐显著增强了亚胺培南和阿米卡星的协同活性。水杨酸盐对多西环素活性的影响最为严重，因为在水杨酸盐水平低至5毫克/升时，抗菌活性就会显著降低。相比之下，其他抗菌剂的抑制活性显著丧失至少需要100毫克/升的水杨酸盐。讨论了水杨酸盐对肺炎克雷伯菌对抗菌剂敏感性的临床意义。
