Hammond G W, Stiver H G
Can Med Assoc J. 1978 Mar 4;118(5):524-30.
The efficacy of combination antibiotics in vivo and in vitro was studied during an outbreak of prosthetic endocarditis caused by Staphylococcus epidermidis in 10 patients. The epidemic curve suggested that patients were infected at the time of their operation, with an interval from that time until diagnosis of 11 days to 20 months. The overall mortality was 50%. Four of six patients treated with gentamicin in combination with a penicillin analogue, a cephalosporin or clindamycin survived without reoperation. One of four patients survived when treated with regimens that did not include gentamicin. In vitro studies showed a median minimum inhibitory concentration for methicillin of 8.0 microgram/mL, compared with 0.1 microgram/mL for cephalothin, clindamycin and gentamicin, and a synergistic bactericidal effect between gentamicin and methicillin, cephalothin or clindamycin. These data suggest that gentamicin is a valuable component of combination antibiotic therapy in prosthetic endocarditis caused by S. epidermidis.
在10例由表皮葡萄球菌引起的人工瓣膜心内膜炎暴发期间，对联合使用抗生素的体内和体外疗效进行了研究。流行曲线表明，患者在手术时被感染，从那时起到诊断的间隔时间为11天至20个月。总死亡率为50%。6例接受庆大霉素联合青霉素类似物、头孢菌素或克林霉素治疗的患者中有4例存活，无需再次手术。4例接受不包括庆大霉素治疗方案的患者中有1例存活。体外研究显示，甲氧西林的最低抑菌浓度中位数为8.0微克/毫升，而头孢噻吩、克林霉素和庆大霉素为0.1微克/毫升，庆大霉素与甲氧西林、头孢噻吩或克林霉素之间具有协同杀菌作用。这些数据表明，庆大霉素是治疗表皮葡萄球菌引起的人工瓣膜心内膜炎联合抗生素治疗的重要组成部分。
