Maskell J P, Sefton A M, Cannell H, Kerawala C, Seymour A, Sun Z M, Williams J D
Department of Medical Microbiology, London Hospital Medical College, UK.
J Antimicrob Chemother. 1990 Oct;26(4):539-48. doi: 10.1093/jac/26.4.539.
We have investigated the influence of the macrolides erythromycin and josamycin on the selection of resistant oral streptococci by sampling saliva of volunteers before and after oral administration of 1.5 g of either agent followed by a further 0.5 g of the same drug after 6 h, as in routine prophylaxis for oral or dental procedures. The small proportion of resistant organisms present before antibiotic administration increased substantially 48 h after the macrolides were given. After antibiotic administration mean counts of oral streptococci resistant to 1, 4 and 64 mg/l erythromycin were 23%, 17% and 6%, respectively, of the total numbers of streptococci isolated; after josamycin, the values were 13%, 6% and 4% respectively. The proportion of resistant streptococci then declined gradually but remained above pre-antibiotic levels three months later. Streptococci isolated on media containing 64 mg/l of macrolides were mainly Streptococcus sanguis and S. mitis with one isolate of S. salivarius; the majority were resistant to 256 mg/l erythromycin, josamycin, all other macrolides tested and clindamycin. Amoxycillin and pristinamycin were the only compounds tested that were inhibitory to these organisms at therapeutically attainable concentrations.
我们通过采集志愿者口服1.5克红霉素或交沙霉素（如同口腔或牙科手术的常规预防措施一样，6小时后再服用0.5克相同药物）前后的唾液样本，研究了这两种大环内酯类药物对口腔链球菌耐药性选择的影响。在给予大环内酯类药物48小时后，抗生素给药前存在的少量耐药菌数量大幅增加。抗生素给药后，对1毫克/升、4毫克/升和64毫克/升红霉素耐药的口腔链球菌平均数量分别占分离出的链球菌总数的23%、17%和6%；给予交沙霉素后，相应数值分别为13%、6%和4%。随后，耐药链球菌的比例逐渐下降，但三个月后仍高于抗生素给药前的水平。在含有64毫克/升大环内酯类药物的培养基上分离出的链球菌主要是血链球菌和缓症链球菌，有一株唾液链球菌；大多数菌株对256毫克/升红霉素、交沙霉素、所有其他测试的大环内酯类药物和克林霉素耐药。阿莫西林和 pristinamycin是仅有的在治疗可达到的浓度下对这些菌株有抑制作用的测试化合物。
