Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, Assistance-Publique Hôpitaux de Paris, Paris, France.
Inserm, IAME, UMR 1137, Université Paris Diderot, Paris, France.
J Antimicrob Chemother. 2019 Dec 1;74(12):3511-3514. doi: 10.1093/jac/dkz388.
The combination of amoxicillin with cefazolin could be an interesting regimen for the empirical therapy of severe infective endocarditis, but its activity against enterococci is unknown.
To evaluate in vitro the bactericidal activity of the combination of amoxicillin with different cephalosporins including cefazolin.
Combinations of amoxicillin (at MIC×¼) with cefazolin, cefotaxime, ceftriaxone, cefepime, ceftaroline or ceftobiprole (at the mean free plasma concentration) were studied using time-kill experiments for 10 endocarditis-associated Enterococcus faecalis strains and 2 reference strains.
The combinations amoxicillin/cefazolin, amoxicillin/cefotaxime, amoxicillin/ceftriaxone and amoxicillin/cefepime were synergistic at 12 and 24 h against 12/12 strains and amoxicillin/ceftobiprole and amoxicillin/ceftaroline against 10/12 strains. The combination amoxicillin/cefepime was bactericidal at 24 h against 9/12 strains, the combination amoxicillin/cefazolin against 8/12 strains, the combinations amoxicillin/ceftaroline, amoxicillin/cefotaxime and amoxicillin/ceftobiprole against 7/12 strains and the combination amoxicillin/ceftriaxone against 6/12 strains.
The combination amoxicillin/cefazolin is as synergistic and bactericidal in vitro as amoxicillin/cefotaxime or amoxicillin/ceftriaxone against E. faecalis.
阿莫西林与头孢唑林联合用药可能是治疗严重感染性心内膜炎经验性治疗的一种有趣方案，但对肠球菌的作用尚不清楚。
评估阿莫西林与不同头孢菌素（包括头孢唑林）联合用药的杀菌活性。
采用时间杀菌实验，研究了阿莫西林（MIC×¼）与头孢唑林、头孢噻肟、头孢曲松、头孢吡肟、头孢托罗、头孢比普联合应用对 10 株与心内膜炎相关的粪肠球菌和 2 株参考菌株的杀菌活性。
阿莫西林/头孢唑林、阿莫西林/头孢噻肟、阿莫西林/头孢曲松和阿莫西林/头孢吡肟联合用药在 12 和 24 小时时对 12/12 株菌表现为协同作用，阿莫西林/头孢比普和阿莫西林/头孢托罗联合用药对 10/12 株菌表现为协同作用。阿莫西林/头孢吡肟联合用药在 24 小时时对 9/12 株菌具有杀菌作用，阿莫西林/头孢唑林联合用药对 8/12 株菌具有杀菌作用，阿莫西林/头孢托罗、阿莫西林/头孢噻肟和阿莫西林/头孢比普联合用药对 7/12 株菌具有杀菌作用，阿莫西林/头孢曲松联合用药对 6/12 株菌具有杀菌作用。
阿莫西林/头孢唑林联合用药在体外对粪肠球菌的协同作用和杀菌作用与阿莫西林/头孢噻肟或阿莫西林/头孢曲松相似。
