妥布霉素、阿米卡星和庆大霉素单独及与羧苄西林联合使用对铜绿假单胞菌的比较活性
Comparative activity of tobramycin, amikacin, and gentamicin alone and with carbenicillin against Pseudomonas aeruginosa.
作者信息
Kluge R M, Standiford H C, Tatem B, Young V M, Greene W H, Schimpff S C, Calia F M, Hornick R B
出版信息
Antimicrob Agents Chemother. 1974 Oct;6(4):442-6. doi: 10.1128/AAC.6.4.442.
The effect of gentamicin against 130 clinical isolates of Pseudomonas aeruginosa was compared with that of two investigational aminoglycoside antibiotics, tobramycin and amikacin. Minimal inhibitory concentration data indicated that, on a weight basis, tobramycin was two to four times as active as gentamicin against most isolates. However, 14 of 18 organisms highly resistant to gentamicin (>/=80 mug/ml) were also highly resistant to tobramycin. Amikacin was the least active aminoglycoside on a weight basis, but none of the isolates were highly resistant to this antibiotic. When therapeutically achievable concentrations were used, adding carbenicillin to gentamicin or to tobramycin enhanced inhibitory activity against those isolates susceptible (</=5 mug/ml) or moderately resistant (10 to 40 mug/ml) to the aminoglycoside. Such synergy was seldom demonstrated for isolates highly resistant to gentamicin or tobramycin. The combination of carbenicillin and amikacin enhanced inhibition against all but two of the isolates. Both tobramycin and amikacin offer in vitro advantages over gentamicin against P. aeruginosa.
将庆大霉素对130株铜绿假单胞菌临床分离株的作用与两种研究用氨基糖苷类抗生素妥布霉素和阿米卡星进行了比较。最低抑菌浓度数据表明，以重量计，妥布霉素对大多数分离株的活性是庆大霉素的两到四倍。然而，对庆大霉素高度耐药（≥80μg/ml）的18株菌中有14株对妥布霉素也高度耐药。以重量计，阿米卡星是活性最低的氨基糖苷类抗生素，但没有分离株对该抗生素高度耐药。当使用治疗可达到的浓度时，在庆大霉素或妥布霉素中加入羧苄西林可增强对那些对氨基糖苷类敏感（≤5μg/ml）或中度耐药（10至40μg/ml）的分离株的抑制活性。对于对庆大霉素或妥布霉素高度耐药的分离株，很少表现出这种协同作用。羧苄西林和阿米卡星的联合用药增强了对除两株分离株外所有分离株的抑制作用。与庆大霉素相比，妥布霉素和阿米卡星在体外对铜绿假单胞菌均具有优势。
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