Greenwood D
Infection. 1986 Jul-Aug;14(4):186-9. doi: 10.1007/BF01645261.
The response to trometamol fosfomycin of four strains of Escherichia coli was studied in an in vitro model in which the hydrokinetic aspects of the treatment of bacterial cystitis can be stimulated. Two strains of E. coli that were fully susceptible to fosfomycin, and a strain of intermediate susceptibility responded well to relatively low concentrations of the trometamol salt: doses achieving peak concentrations of 50 or 250 mg/l suppressed bacterial growth for at least 18 h; however, the emergence of resistance was completely suppressed only when a peak concentration of 2500 mg/l was achieved in the bladder model. A strain of E. coli that was fully resistant to fosfomycin in conventional minimum inhibitory concentration titrations responded to the highest dosage used, but this did not prevent further resistance from emerging. These results were obtained in the absence of the potentiating agent, glucose-6-phosphate, which is commonly used in susceptibility tests of fosfomycin. The implications of the results for fosfomycin dosage in bacterial cystitis and for the interpretation of susceptibility tests is discussed.
在一个能够模拟细菌性膀胱炎治疗流体动力学情况的体外模型中，研究了四株大肠杆菌对磷霉素三乙醇胺盐的反应。两株对磷霉素完全敏感的大肠杆菌菌株以及一株中度敏感的菌株，对相对低浓度的三乙醇胺盐反应良好：达到50或250mg/L峰值浓度的剂量可抑制细菌生长至少18小时；然而，只有当膀胱模型中达到2500mg/L的峰值浓度时，耐药性的出现才被完全抑制。在传统最低抑菌浓度滴定中对磷霉素完全耐药的一株大肠杆菌，对所使用的最高剂量有反应，但这并不能阻止进一步耐药性的出现。这些结果是在没有常用的增效剂6-磷酸葡萄糖的情况下获得的。讨论了这些结果对细菌性膀胱炎中磷霉素剂量以及药敏试验解读的意义。
