Davey P G, Barza M
New England Medical Center, Division of Geographic Medicine and Infectious Diseases, Boston, MA 02111.
J Antimicrob Chemother. 1987 Nov;20(5):639-44. doi: 10.1093/jac/20.5.639.
The in-vitro MICs and MBCs of ciprofloxacin, cefoperazone, ceftazidime, ceftriaxone, gentamicin and imipenem were measured for five strains each of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa with standard and high inocula. The MBC was raised more than the MIC at the higher inoculum for all the drugs except ciprofloxacin. However, the MBC of imipenem against P. aeruginosa was increased relatively little at the higher inoculum in contrast to the findings with other beta-lactam drugs. In a rabbit model of endophthalmitis both cefoperazone and imipenem were markedly more bactericidal against a high inoculum of K. pneumoniae than would have been predicted from the results of in-vitro time kill curve studies. We conclude that the therapeutic relevance of the inoculum effect remains to be proved.
对大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌的5个菌株，分别用标准接种量和高接种量测定了环丙沙星、头孢哌酮、头孢他啶、头孢曲松、庆大霉素和亚胺培南的体外最低抑菌浓度（MIC）和最低杀菌浓度（MBC）。除环丙沙星外，所有药物在高接种量时的MBC升高幅度均大于MIC。然而，与其他β-内酰胺类药物的结果相反，亚胺培南对铜绿假单胞菌的MBC在高接种量时升高相对较小。在兔眼内炎模型中，头孢哌酮和亚胺培南对高接种量的肺炎克雷伯菌的杀菌作用均明显强于体外时间杀菌曲线研究所预测的效果。我们得出结论，接种量效应的治疗相关性仍有待证实。
