Modak S, Fox C L
J Trauma. 1985 Jan;25(1):27-31. doi: 10.1097/00005373-198501000-00005.
Silver sulfadiazine-resistant organisms are arising at an irregular rate and may eventually interfere with wound management. To counter this problem several new antibacterial agents were tested in combination with silver sulfadiazine. Only sodium piperacillin (Pipracil, Lederle) exhibited synergism with silver sulfadiazine both in vitro (against various species of organisms) and in burned animals. The MIC of AgSD and Pipracil was 50 nmole/ml and 250 nmole/ml, respectively, but a combination of 6 nmole/ml of AgSD and 7.5 nmole/ml of Pipracil inhibited the growth of Pseudomonas aeruginosa. In burned mice infected with either AgSD-resistant or sensitive strains, the mortality in groups receiving combinations of topical Pipracil and silver sulfadiazine was 0-10%; in contrast, treatment with Pipracil or silver sulfadiazine alone resulted in much higher mortality. Thus it would appear that a combination of silver sulfadiazine and Pipracil, each of which have long been used in patients topically and parenterally, may prove valuable in patients with burn wound infections related to or caused by organisms resistant to silver sulfadiazine.
耐磺胺嘧啶银的微生物正以不规则的速率出现，最终可能会干扰伤口处理。为应对这一问题，几种新型抗菌剂与磺胺嘧啶银联合进行了测试。只有哌拉西林钠（派拉西林，礼来公司）在体外（针对各种微生物）和烧伤动物体内均与磺胺嘧啶银表现出协同作用。磺胺嘧啶银和哌拉西林的最低抑菌浓度分别为50纳摩尔/毫升和250纳摩尔/毫升，但6纳摩尔/毫升的磺胺嘧啶银与7.5纳摩尔/毫升的哌拉西林联合使用可抑制铜绿假单胞菌的生长。在感染了耐磺胺嘧啶银或敏感菌株的烧伤小鼠中，接受局部哌拉西林和磺胺嘧啶银联合治疗组的死亡率为0 - 10%；相比之下，单独使用哌拉西林或磺胺嘧啶银治疗导致的死亡率要高得多。因此，长期以来分别在患者局部和肠道外使用的磺胺嘧啶银和哌拉西林联合使用，可能对与耐磺胺嘧啶银的微生物相关或由其引起的烧伤创面感染患者有价值。
