Hemsell D L
Drugs. 1986;31 Suppl 2:22-5. doi: 10.2165/00003495-198600312-00006.
The increasing number of beta-lactam antibiotic-resistant bacteria observed in many strains of aerobic and anaerobic Gram-positive and Gram-negative bacteria, including Bacteroides species, has been well documented. Semisynthetic synthesis of penicillins and cephalosporins with increased resistance to beta-lactamase enzyme hydrolysis has not solved the problem. An alternative to therapy with newer agents is combination of an irreversible, suicide-type, beta-lactamase enzyme inhibitor such as sulbactam with a beta-lactam antibiotic such as ampicillin. Women with a variety of acute polymicrobial pelvic infections have been treated with the above combination, metronidazole or clindamycin combined with aminoglycoside, or cefoxitin in prospective trials. The clinical efficacy of 92.4%, in vitro bacteriological efficacy of 96.6%, and safety of sulbactam/ampicillin were comparable to that observed in women given comparative therapy. Penetration of pelvic tissues by sulbactam and ampicillin was excellent. Sulbactam/ampicillin is a viable alternative for the treatment of women with acute pelvic infections.
在包括拟杆菌属在内的许多需氧和厌氧革兰氏阳性及革兰氏阴性细菌菌株中，观察到对β-内酰胺类抗生素耐药的细菌数量不断增加，这已得到充分记录。合成对β-内酰胺酶水解具有更高耐药性的半合成青霉素和头孢菌素并不能解决这一问题。使用新型药物进行治疗的一种替代方法是将不可逆的、自杀型β-内酰胺酶抑制剂（如舒巴坦）与β-内酰胺类抗生素（如氨苄西林）联合使用。在一些前瞻性试验中，患有各种急性多微生物盆腔感染的女性接受了上述联合用药、甲硝唑或克林霉素联合氨基糖苷类药物治疗，或头孢西丁治疗。舒巴坦/氨苄西林的临床有效率为92.4%，体外细菌学有效率为96.6%，其安全性与接受对照治疗的女性相当。舒巴坦和氨苄西林在盆腔组织中的穿透力极佳。舒巴坦/氨苄西林是治疗急性盆腔感染女性的一种可行替代药物。
