抗菌药物对鸟分枝杆菌复合群的抑制与杀灭作用的治疗意义。
Therapeutic implications of inhibition versus killing of Mycobacterium avium complex by antimicrobial agents.
作者信息
Yajko D M, Nassos P S, Hadley W K
出版信息
Antimicrob Agents Chemother. 1987 Jan;31(1):117-20. doi: 10.1128/AAC.31.1.117.
Abstract
Patients with the acquired immune deficiency syndrome (AIDS) with disseminated Mycobacterium avium infection have responded poorly to treatment with rifabutine (Ansamycin) and clofazimine, in spite of the good in vitro response of M. avium to these antimicrobial agents. We compared the ability of these and other antimicrobial agents to kill versus the ability to inhibit the growth of strains of the M. avium complex isolated from patients with AIDS. Killing curve experiments showed that the concentrations of rifabutine and clofazimine needed to kill two log units of M. avium are at least 32 times greater than the concentrations needed to inhibit growth. Little or no killing occurred at concentrations of these antimicrobial agents that are achievable in serum. In contrast, five of seven strains tested were killed by ciprofloxacin at concentrations that can be achieved in serum. Ciprofloxacin should be studied further for possible use in the treatment of M. avium infections.
摘要
患有获得性免疫缺陷综合征（艾滋病）且伴有播散性鸟分枝杆菌感染的患者，尽管鸟分枝杆菌在体外对利福布汀（安莎霉素）和氯法齐明有良好反应，但对这两种药物治疗的反应却很差。我们比较了这些抗菌药物与其他抗菌药物对从艾滋病患者分离出的鸟分枝杆菌复合群菌株的杀菌能力与抑制生长能力。杀菌曲线实验表明，杀死两个对数单位的鸟分枝杆菌所需的利福布汀和氯法齐明浓度至少比对其生长抑制所需浓度高32倍。在血清中可达到的这些抗菌药物浓度下，几乎没有或根本没有杀菌作用。相比之下，所测试的七株菌株中有五株在血清中可达到的环丙沙星浓度下被杀死。环丙沙星在治疗鸟分枝杆菌感染方面的潜在用途应进一步研究。
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