非甾体抗炎药（NSAIDs）对头孢呋辛和氯霉素对耐甲氧西林金黄色葡萄球菌的抗菌活性的协同作用。
Synergistic effect of non-steroidal anti-inflammatory drugs (NSAIDs) on antibacterial activity of cefuroxime and chloramphenicol against methicillin-resistant Staphylococcus aureus.
机构信息
Institute of Research, Development and Innovations, International Medical University, 126 Jalan 19/155B, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
School of Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
出版信息
J Glob Antimicrob Resist. 2017 Sep;10:70-74. doi: 10.1016/j.jgar.2017.03.012. Epub 2017 Jun 30.
OBJECTIVES
Currently, only a few antibiotics are available to treat methicillin-resistant Staphylococcus aureus (MRSA). One alternative approach includes adjuvants to antibiotic therapy. Non-steroidal anti-inflammatory drugs (NSAIDs) are non-antibiotic drugs reported to exhibit antibacterial activity. The objective of this study was to investigate the interaction between NSAIDs with selected antibiotics (cefuroxime and chloramphenicol) against strains of S. aureus.
METHODS
The antibacterial activity of four NSAIDs (aspirin, ibuprofen, diclofenac and mefenamic acid) were tested against ten pathogenic bacterial strains using the microdilution broth method. The interaction between NSAIDs and antibiotics (cefuroxime/chloramphenicol) was estimated by calculating the fractional inhibitory concentration (FICI) of the combination.
RESULTS
Aspirin, ibuprofen and diclofenac exhibited antibacterial activity against the selected pathogenic bacteria. The interaction between ibuprofen/aspirin with cefuroxime was demonstrated to be synergistic against methicillin-sensitive S. aureus (MSSA) and the MRSA reference strain, whereas for MRSA clinical strains additive effects were observed for both NSAIDs and cefuroxime combinations. The combination of chloramphenicol with ibuprofen/aspirin was synergistic against all of the tested MRSA strains and displayed an additive effect against MSSA. A 4-8192-fold reduction in the cefuroxime minimum inhibitory concentration (MIC) and a 4-64-fold reduction of the chloramphenicol MIC were documented.
CONCLUSIONS
Overall, the NSAIDs ibuprofen and aspirin showed antibacterial activity against strains of S. aureus. Although individually less potent than common antibiotics, these NSAIDs are synergistic in action with cefuroxime and chloramphenicol and could potentially be used as adjuvants in combating multidrug-resistant MRSA.
目的
目前，仅有少数几种抗生素可用于治疗耐甲氧西林金黄色葡萄球菌（MRSA）。一种替代方法包括抗生素治疗的佐剂。非甾体抗炎药（NSAIDs）是具有抗菌活性的非抗生素药物。本研究的目的是研究 NSAIDs 与选定的抗生素（头孢呋辛和氯霉素）与金黄色葡萄球菌菌株的相互作用。
方法
采用微量肉汤稀释法检测四种 NSAIDs（阿司匹林、布洛芬、双氯芬酸和甲芬那酸）对十种致病菌的抗菌活性。通过计算组合的部分抑菌浓度（FICI）来评估 NSAIDs 和抗生素（头孢呋辛/氯霉素）之间的相互作用。
结果
阿司匹林、布洛芬和双氯芬酸对选定的致病菌表现出抗菌活性。布洛芬/阿司匹林与头孢呋辛的相互作用被证明对甲氧西林敏感金黄色葡萄球菌（MSSA）和 MRSA 参考菌株具有协同作用，而对于 MRSA 临床分离株，两种 NSAIDs 和头孢呋辛组合均表现出相加作用。氯霉素与布洛芬/阿司匹林的组合对所有测试的 MRSA 菌株均具有协同作用，并对 MSSA 显示出相加作用。头孢呋辛的最低抑菌浓度（MIC）降低了 4-8192 倍，氯霉素的 MIC 降低了 4-64 倍。
结论
总体而言，NSAIDs 布洛芬和阿司匹林对金黄色葡萄球菌菌株表现出抗菌活性。尽管它们的个体效力低于常见抗生素，但这些 NSAIDs 与头孢呋辛和氯霉素协同作用，可能可作为治疗耐多药 MRSA 的佐剂。
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