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拉氧头孢联合氨基糖苷类药物治疗铜绿假单胞菌:与替卡西林的相似性

Latamoxef in combination with aminoglycosides against Pseudomonas aeruginosa: similarity with ticarcillin.

作者信息

Sears S D, Tatem B A, Standiford H C

出版信息

Chemotherapy. 1985;31(2):102-11. doi: 10.1159/000238321.

Abstract

The in vitro effect of latamoxef against 50 clinical strains of Pseudomonas aeruginosa was compared to that of ticarcillin, both alone and in combination with the aminoglycosides gentamicin, tobramycin and amikacin. Alone, the MIC90 of latamoxef was consistently one-half the MIC90 of ticarcillin. The two antibiotics appeared similar in regard to inoculum effect and bacterial killing. Adding of one-quarter the minimum inhibitory concentration of the aminoglycoside antibiotic to the beta lactam caused reduction in MIC90 of the latter (either ticarcillin or latamoxef) by one-half and decreased the MIC50 by almost one-quarter the concentration required by the beta lactams singly. Therefore, latamoxef singly or in combination with aminoglycosides behaved similarly but was more active than ticarcillin. Using combinations of antibiotics likely to be achieved in the serum of patients, a beneficial in vitro effect (either additive, partially synergistic or synergistic) generally occurred for the beta lactam-aminoglycoside combination if the strain was relatively sensitive to the aminoglycoside used in this combination. It occurred much less frequently for the highly aminoglycoside-resistant isolates.

摘要

将拉氧头孢对50株铜绿假单胞菌临床菌株的体外作用与替卡西林进行比较,替卡西林单独使用以及与氨基糖苷类抗生素庆大霉素、妥布霉素和阿米卡星联合使用时的情况也一并进行比较。单独使用时,拉氧头孢的MIC90始终是替卡西林MIC90的一半。这两种抗生素在接种量效应和细菌杀灭方面表现相似。向β-内酰胺类抗生素中添加四分之一最小抑菌浓度的氨基糖苷类抗生素可使后者(替卡西林或拉氧头孢)的MIC90降低一半,并使MIC50降低至β-内酰胺类抗生素单独使用时所需浓度的近四分之一。因此,拉氧头孢单独使用或与氨基糖苷类抗生素联合使用时表现相似,但比替卡西林更具活性。使用患者血清中可能达到的抗生素组合,如果菌株对该组合中使用的氨基糖苷类抗生素相对敏感,β-内酰胺类-氨基糖苷类组合通常会产生有益的体外效应(相加、部分协同或协同)。对于高度耐氨基糖苷类的分离株,这种情况发生的频率要低得多。

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