R. M. Alden Research Laboratory, Culver City, CA, USA.
Antimicrob Agents Chemother. 2012 Dec;56(12):6319-23. doi: 10.1128/AAC.01794-12. Epub 2012 Oct 1.
More than 5 million Americans are bitten by animals, usually dogs, annually. Bite patients comprise ∼1% of all patients who visit emergency departments (300,000/year), and approximately 10,000 require hospitalization and intravenous antibiotics. Ceftaroline is the bioactive component of the prodrug ceftaroline fosamil, which is FDA approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs), including those containing methicillin-resistant Staphylococcus aureus (MRSA). There are no in vitro data about the activity of ceftaroline against Pasteurella multocida subsp. multocida and Pasteurella multocida subsp. septica, other Pasteurella spp., or other bite wound isolates. We therefore studied the in vitro activity of ceftaroline against 243 animal bite isolates. MICs were determined using the broth microdilution method according to CLSI guidelines. Comparator drugs included cefazolin, ceftriaxone, ertapenem, ampicillin-sulbactam, azithromycin, doxycycline, and sulfamethoxazole-trimethoprim (SMX-TMP). Ceftaroline was the most active agent against all 5 Pasteurella species, including P. multocida subsp. multocida and P. multocida subsp. septica, with a maximum MIC of ≤0.008 μg/ml; more active than ceftriaxone and ertapenem (MIC(90)s, ≤0.015 μg/ml); and more active than cefazolin (MIC(90), 0.5 μg/ml) doxycycline (MIC(90), 0.125 μg/ml), azithromycin (MIC(90), 0.5 μg/ml), ampicillin-sulbactam (MIC(90), 0.125 μg/ml), and SMX-TMP (MIC(90), 0.125 μg/ml). Ceftaroline was also very active against all S. aureus isolates (MIC(90), 0.125 μg/ml) and other Staphylococcus and Streptococcus species, with a maximum MIC of 0.125 μg/ml against all bite isolates tested. Ceftaroline has potential clinical utility against infections involving P. multocida, other Pasteurella species, and aerobic Gram-positive isolates, including S. aureus.
超过 500 万美国人每年被动物咬伤，通常是狗。咬伤患者占每年就诊急诊的所有患者的约 1%（30 万例），约 1 万人需要住院治疗和静脉注射抗生素。头孢洛林是前体药物头孢洛林磷酸酯的生物活性成分，已获 FDA 批准用于治疗急性细菌性皮肤和皮肤结构感染（ABSSSIs），包括耐甲氧西林金黄色葡萄球菌（MRSA）引起的感染。目前尚无关于头孢洛林对多杀巴斯德菌亚种和杀巴斯德菌亚种的活性的体外数据，其他巴斯德菌属、或其他咬伤伤口分离株。因此，我们研究了头孢洛林对 243 种动物咬伤分离株的体外活性。采用肉汤微量稀释法根据 CLSI 指南测定 MIC。比较药物包括头孢唑林、头孢曲松、厄他培南、氨苄西林-舒巴坦、阿奇霉素、多西环素和磺胺甲噁唑-甲氧苄啶（SMX-TMP）。头孢洛林对所有 5 种巴斯德菌属（包括多杀巴斯德菌亚种和杀巴斯德菌亚种）均具有最强的活性，最大 MIC 为≤0.008 μg/ml；比头孢曲松和厄他培南（MIC90s，≤0.015 μg/ml）更有效；比头孢唑林（MIC90，0.5 μg/ml）、多西环素（MIC90，0.125 μg/ml）、阿奇霉素（MIC90，0.5 μg/ml）、氨苄西林-舒巴坦（MIC90，0.125 μg/ml）和 SMX-TMP（MIC90，0.125 μg/ml）更有效。头孢洛林对所有金黄色葡萄球菌分离株（MIC90，0.125 μg/ml）和其他葡萄球菌属和链球菌属也具有很强的活性，对所有测试的咬伤分离株的最大 MIC 为 0.125 μg/ml。头孢洛林对涉及多杀巴斯德菌、其他巴斯德菌属和需氧革兰阳性菌的感染具有潜在的临床应用价值，包括金黄色葡萄球菌。
