Raz R, Sharir R, Shmilowitz L, Kenes I, Ephros M
Infection. 1987 Jan-Feb;15(1):32-4. doi: 10.1007/BF01646115.
The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin-resistant E. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced.
氨基糖苷类药物在治疗由革兰氏阴性菌引起的传染病中发挥着核心作用。1984年1月至6月期间，我们新生儿重症监护病房采集的45份临床标本培养出阴沟肠杆菌；其中41份对庆大霉素耐药。一名新生儿发生了败血症。随后，常规抗生素方案从庆大霉素-氨苄西林改为阿米卡星-氨苄西林，持续了六个月。在此期间，对庆大霉素的耐药性降至最低。122份标本中只有8份被证明含有对庆大霉素耐药的革兰氏阴性菌。耐庆大霉素的阴沟肠杆菌消失了。没有分离株对阿米卡星耐药。然后重新引入了庆大霉素-氨苄西林方案。
