Zuravleff J J, Yu V L, Yee R B
J Lab Clin Med. 1983 Jun;101(6):896-902.
MICs of ticarcillin, tobramycin, and rifampin alone and in combination were determined by a three-dimensional checkerboard method for 33 isolates of Pseudomonas aeruginosa. Twenty-nine of 33 isolates were affected synergistically (FIC index less than 1.0) by the combination of ticarcillin-tobramycin, including 13 of the 16 isolates resistant to ticarcillin and/or tobramycin alone. However, despite fulfilling the criteria for synergy, the MIC of the ticarcillin and/or tobramycin when in combination still exceeded attainable serum concentrations for 12 of the 13 resistant isolates. When rifampin was added to ticarcillin-tobramycin, a synergistic interaction was observed for all 33 isolates. Furthermore, of the 16 isolates resistant to ticarcillin and/or tobramycin, eight were inhibited by attainable concentrations of all three antibiotics in combination. If these results can be confirmed in the clinical situation, application of the three-drug combination of ticarcillin-tobramycin-rifampin might improve survival in selected patients with serious P. aeruginosa infections.
采用三维棋盘法测定了33株铜绿假单胞菌对替卡西林、妥布霉素和利福平单独及联合使用时的最低抑菌浓度（MIC）。33株分离菌中，29株对替卡西林-妥布霉素联合用药呈现协同作用（FIC指数小于1.0），其中16株单独对替卡西林和/或妥布霉素耐药的分离菌中有13株呈现协同作用。然而，尽管符合协同作用标准，但13株耐药分离菌中有12株在联合用药时替卡西林和/或妥布霉素的MIC仍超过可达到的血清浓度。当利福平加入替卡西林-妥布霉素联合用药中时，所有33株分离菌均观察到协同相互作用。此外，16株对替卡西林和/或妥布霉素耐药的分离菌中，有8株被三种抗生素联合使用时可达到的浓度所抑制。如果这些结果能在临床中得到证实，替卡西林-妥布霉素-利福平三联药物组合的应用可能会提高部分严重铜绿假单胞菌感染患者的生存率。
