Niederau W, Pape W, Schaal K P, Höffler U, Pulverer G
Dtsch Med Wochenschr. 1982 Aug 27;107(34):1279-83. doi: 10.1055/s-2008-1070115.
In the complex aetiology of human actinomykoses, various Actinomyces species, especially A. israelii, play the pathogenetically leading role in the mixed flora so typical for these diseases. A number of other microaerophilic and anaerobic bacteria are also part of such mixed flora. Since these "concomitant" bacteria are themselves potentially pathogenic, it is important to have data on antibiotic sensitivity for the entire spectrum of microorganisms, to achieve effective and economic chemotherapy of human actinomykoses. Minimal inhibitory concentrations of antibiotics were determined for Actinomyces and the most important concomitant bacteria from actinomykotic processes: Actinobacillus actinomycetem-commitants, Bacteroides of the Melaninogenicus group, B. fragilis, B. theta-iotaomicron, Fusobacterium nucleatum, Fusobacterium spp. and Propionibacteria. The results indicate that aminopenicillines are the drug of first choice, if in the actinomykoses there are no Bacteroides strains resistant to beta-lactam antibiotics. These tests further indicate that clinically the combination of aminopenicillin and clindamycin, as well as aminopenicillin and metronidazol, are indicated. Minocycline and especially cefoxitin, a beta-lactamase resistant cephalosporin, inhibit with few exceptions all bacteria which are potentially involved in actinomykotic processes.
在人类放线菌病复杂的病因中，各种放线菌属，尤其是以色列放线菌，在这些疾病特有的混合菌群中起着致病的主导作用。许多其他微需氧菌和厌氧菌也是这种混合菌群的一部分。由于这些“伴随”细菌本身具有潜在致病性，因此掌握整个微生物谱的抗生素敏感性数据对于实现人类放线菌病的有效和经济化疗至关重要。测定了放线菌以及放线菌病病变中最重要的伴随细菌的抗生素最低抑菌浓度：放线共生放线杆菌、产黑素类杆菌属、脆弱拟杆菌、θ-艾奥塔微单胞菌、具核梭杆菌、梭杆菌属和丙酸杆菌属。结果表明，如果放线菌病中不存在对β-内酰胺类抗生素耐药的拟杆菌菌株，氨基青霉素是首选药物。这些试验还表明，临床上氨基青霉素与克林霉素以及氨基青霉素与甲硝唑联合使用是适用的。米诺环素，尤其是头孢西丁（一种耐β-内酰胺酶的头孢菌素），几乎能抑制所有可能参与放线菌病病变过程的细菌。
