Hooton T M, Blair A D, Turck M, Counts G W
Antimicrob Agents Chemother. 1984 Oct;26(4):535-8. doi: 10.1128/AAC.26.4.535.
We evaluated the in vitro synergistic activity at clinically attainable concentrations of combinations of aminoglycoside and beta-lactam antibiotics against 30 gentamicin-resistant clinical isolates of gram-negative bacilli. All 56 pairs of 4 aminoglycosides and 14 beta-lactams were evaluated. Combinations with amikacin demonstrated inhibitory synergistic activity in 29% of the assays, as compared with 22% for netilmicin (P = 0.018), 17% for gentamicin (P less than 0.001), and 13% for tobramycin (P less than 0.001). Among the beta-lactams, combinations with cefoperazone, ceftriaxone, or cefpiramide (SM-1652) demonstrated inhibitory synergistic activity most often (39, 38, and 35% of the assays, respectively) and with ceforanide, cefsulodin, and imipenem least often (less than or equal to 8% each). The most active combination was amikacin and ceftriaxone, with which 67% of the assays demonstrated inhibitory synergism. Isolates with high-level resistance to either antibiotic in a combination were unlikely to be inhibited synergistically by the combination. Further, combinations generally demonstrated little synergistic activity against isolates highly susceptible to beta-lactams.
我们评估了氨基糖苷类抗生素与β-内酰胺类抗生素联合使用在临床可达到浓度下对30株耐庆大霉素革兰氏阴性杆菌临床分离株的体外协同活性。对4种氨基糖苷类抗生素和14种β-内酰胺类抗生素的所有56对组合进行了评估。与阿米卡星的组合在29%的试验中表现出抑制性协同活性，奈替米星为22%（P = 0.018），庆大霉素为17%（P小于0.001），妥布霉素为13%（P小于0.001）。在β-内酰胺类抗生素中，与头孢哌酮、头孢曲松或头孢匹胺（SM-1652）的组合表现出抑制性协同活性的频率最高（分别为39%、38%和35%的试验），与头孢尼西、头孢磺啶和亚胺培南的组合表现出抑制性协同活性的频率最低（每种均小于或等于8%）。最具活性的组合是阿米卡星和头孢曲松，67%的试验表明二者具有抑制性协同作用。对组合中任何一种抗生素具有高水平耐药性的分离株不太可能被该组合协同抑制。此外，组合通常对高度敏感于β-内酰胺类抗生素的分离株几乎没有协同活性。
