Thabaut A, Meyran M
Laboratoire de Microbiologie, Hôpital d'instruction des armées Bégin, Saint-Mandé.
Presse Med. 1987 Dec 16;16(43):2167-71.
The combination of new quinolones with beta-lactam antibiotics can be an alternative to the classical use of aminoglycoside-beta-lactam antibiotic combinations. In vitro studies, in particular using cefotaxime-pefloxacin or ofloxacin combinations against Enterobacteria and cefsulodin or ceftazidime with pefloxacin or ofloxacin against P. aeruginosa rarely show evidence of synergistic antibacterial activity when the "static" checker board method is used. In contrast, kinetic bactericidal studies very often show a notable increase in the rapidity of bactericidal activity as well as the disappearance of the frequent secondary regrowth seen after 6 hours with the antibiotics used alone. Techniques studying the development of resistance in vitro show that the combination of pefloxacin-cefotaxime against enterobacteria and pefloxacin-cefsulodin against P. aeruginosa are capable of inhibiting the emergence of resistant variants. These promising results require confirmation by studies using animal models and, above all, by the clinico-microbiological analysis of the results of clinical trials.
新型喹诺酮类药物与β-内酰胺类抗生素联合使用,可替代传统的氨基糖苷类-β-内酰胺类抗生素联合使用方法。体外研究,特别是使用头孢噻肟-培氟沙星或氧氟沙星联合制剂针对肠杆菌属,以及使用头孢磺啶或头孢他啶与培氟沙星或氧氟沙星联合制剂针对铜绿假单胞菌进行研究时,采用“静态”棋盘法很少能显示出协同抗菌活性的证据。相比之下,动态杀菌研究常常显示杀菌活性的速度显著加快,且单独使用抗生素6小时后常见的二次再生长现象消失。体外研究耐药性发展的技术表明,培氟沙星-头孢噻肟联合制剂针对肠杆菌属,以及培氟沙星-头孢磺啶联合制剂针对铜绿假单胞菌,均能够抑制耐药变体的出现。这些有前景的结果需要通过动物模型研究来证实,最重要的是,要通过对临床试验结果进行临床微生物学分析来证实。