Appelbaum P C, Tamim J, Pankuch G A, Aber R C
Chemotherapy. 1983;29(5):337-44. doi: 10.1159/000238217.
Susceptibility of 324 isolates of nonfermentative gram-negative bacteria to cephalothin, cefamandole, cefoxitin, ceftazidime, cefsulodin, and azthreonam was determined by agar dilution and disc diffusion techniques. With the exception of Moraxella species, first- and second-generation cephalosporins were minimally active against nonfermenters tested. Cefsulodin and azthreonam were mainly active against Pseudomonas aeruginosa. In contrast, ceftazidime and ceftriaxone exhibited wider activity spectra. Cefsulodin and ceftazidime were the most active against P. aeruginosa, followed by azthreonam and ceftriaxone. Ceftazidime was the only drug with significant activity against Pseudomonas maltophilia and Pseudomonas fluorescens/Pseudomonas putida, and was also the most active against Pseudomonas cepacia. Acinetobacter calcoaceticus and Alcaligenes strains were most sensitive to ceftazidime, followed by ceftriaxone and azthreonam. Ceftriaxone was the most active against moraxellas, followed by cefamandole/cefoxitin, ceftazidime, cephalothin, cefsulodin, and azthreonam. Ceftazidime was the most active against uncommonly isolated nonfermenters. Results observed in this study reflect a potential use for ceftazidime in therapy of infections caused by most gram-negative nonfermenters; therapy with cefsulodin and azthreonam in nonfermenter infections should be restricted to those caused by P. aeruginosa, and that with ceftriaxone reserved for non-P. aeruginosa infections.
采用琼脂稀释法和纸片扩散法测定了324株非发酵革兰阴性菌对头孢噻吩、头孢孟多、头孢西丁、头孢他啶、头孢磺啶和氨曲南的敏感性。除莫拉菌属外，第一代和第二代头孢菌素对所检测的非发酵菌活性极低。头孢磺啶和氨曲南主要对铜绿假单胞菌有活性。相比之下，头孢他啶和头孢曲松的抗菌谱更广。头孢磺啶和头孢他啶对铜绿假单胞菌活性最强，其次是氨曲南和头孢曲松。头孢他啶是唯一对嗜麦芽窄食单胞菌和荧光假单胞菌/恶臭假单胞菌有显著活性的药物，对洋葱伯克霍尔德菌的活性也最强。醋酸钙不动杆菌和产碱杆菌菌株对头孢他啶最敏感，其次是头孢曲松和氨曲南。头孢曲松对莫拉菌属活性最强，其次是头孢孟多/头孢西丁、头孢他啶、头孢噻吩、头孢磺啶和氨曲南。头孢他啶对罕见分离的非发酵菌活性最强。本研究结果表明，头孢他啶在治疗大多数革兰阴性非发酵菌引起的感染中具有潜在用途；头孢磺啶和氨曲南用于非发酵菌感染的治疗应仅限于由铜绿假单胞菌引起的感染，而头孢曲松则应保留用于非铜绿假单胞菌感染。
