Nakazawa H, Hashimoto T, Nishiura T, Mitsuhashi S
Antimicrob Agents Chemother. 1983 Sep;24(3):437-9. doi: 10.1128/AAC.24.3.437.
Synergism between amoxicillin and clavulanic acid was not expected against cephalosporinase-producing bacterial strains because clavulanic acid has little inhibitory action on cephalosporinases. However, in a clinical trial of BRL 25000 (amoxicillin-clavulanic acid), excellent results were obtained in complicated urinary tract infections caused by Serratia marcescens, Enterobacter cloacae, and Citrobacter freundii strains which produced cephalosporinase and were highly resistant to amoxicillin alone. The good clinical efficacy of BRL 25000 in such urinary tract infections was probably due to the fact that the urinary concentration of clavulanic acid was higher than its minimal inhibitory concentrations for these strains.
由于克拉维酸对头孢菌素酶几乎没有抑制作用，因此预计阿莫西林与克拉维酸之间不存在针对产头孢菌素酶细菌菌株的协同作用。然而，在BRL 25000（阿莫西林-克拉维酸）的一项临床试验中，对于由产头孢菌素酶且单独对阿莫西林高度耐药的粘质沙雷氏菌、阴沟肠杆菌和弗氏柠檬酸杆菌菌株引起的复杂性尿路感染，取得了优异的结果。BRL 25000在这类尿路感染中良好的临床疗效可能是由于克拉维酸在尿液中的浓度高于其对这些菌株的最低抑菌浓度。
