McManus A T, Denton C L, Mason A D
Arch Surg. 1983 Feb;118(2):161-6. doi: 10.1001/archsurg.1983.01390020017003.
Sulfonamide-resistant organisms have been reported as a frequent consequence of the clinical use of sulfadiazine silver. At this burn center, sulfonamide resistance occurred in more than 80% of gram-negative isolates. We tested the requirement for the individual antimicrobial activities of sulfadiazine and silver for the vitro activity of sulfadiazine silver. The sulfadiazine component is not necessary for in vitro sensitivity. In vitro sensitivity to sulfadiazine silver does not consistently predict the presence of therapeutic activity in Pseudomonas aeruginosa-infected rats with burns. We describe an example of a transferable multiple-antibiotic resistance plasmid that contains selectable sulfonamide resistance. The use of sulfadiazine silver can, therefore, lead to the selection of organisms that are resistant not only to sulfonamides but to antibiotics of clinical consequence, and this possible risk must be considered in electing to use the agent.
据报道，使用磺胺嘧啶银进行临床治疗常常会导致产生耐磺胺类药物的微生物。在这个烧伤中心，超过80%的革兰氏阴性菌分离株出现了对磺胺类药物的耐药性。我们测试了磺胺嘧啶银的体外活性对磺胺嘧啶和银各自抗菌活性的需求。磺胺嘧啶成分对于体外敏感性并非必需。对磺胺嘧啶银的体外敏感性并不能始终如一地预测在铜绿假单胞菌感染的烧伤大鼠中是否存在治疗活性。我们描述了一个含有可选择的磺胺类耐药性的可转移多重抗生素耐药质粒的例子。因此，使用磺胺嘧啶银可能会导致选择出不仅对磺胺类药物耐药，而且对具有临床意义的抗生素也耐药的微生物，在选择使用该药物时必须考虑到这种潜在风险。
