Watanakunakorn C
Ann Intern Med. 1982 Sep;97(3):376-8. doi: 10.7326/0003-4819-97-3-376.
Strains of methicillin-resistant Staphylococcus aureus are resistant to other penicillins. The in-vitro susceptibility to the cephalosporins differs among strains. Some strains, susceptible to cephalosporins by the standard disk susceptibility test, are proved resistant by the quantitative dilution test; they may show pop-up colonies within the zone of inhibition when incubated further at room temperature. The clinical efficacy of the cephalosporins with or without an aminoglycoside in treating infections due to methicillin-resistant S. aureus is in doubt. To date, susceptible to vancomycin. In-vitro antagonism of vancomycin and rifampin against S. aureus has been shown. Thus, vancomycin alone appears to be the treatment of choice; if this treatment fails, aminoglycoside or rifampin should be added. Serum bactericidal titers should be carefully monitored before and after the addition of the new agent and in-vitro time-kill studies of combination of antibiotics done if feasible.
耐甲氧西林金黄色葡萄球菌菌株对其他青霉素类也耐药。各菌株对头孢菌素的体外敏感性有所不同。一些菌株通过标准纸片药敏试验对头孢菌素敏感，但经定量稀释试验证明耐药；当在室温下进一步培养时，它们可能在抑菌圈内出现突现菌落。头孢菌素联合或不联合氨基糖苷类治疗耐甲氧西林金黄色葡萄球菌所致感染的临床疗效尚不确定。迄今为止，该菌对万古霉素敏感。已证实万古霉素和利福平对金黄色葡萄球菌有体外拮抗作用。因此，单独使用万古霉素似乎是首选治疗方法；如果这种治疗失败，应加用氨基糖苷类或利福平。在添加新药物前后应仔细监测血清杀菌效价，如有可能应进行抗生素联合的体外时间杀菌研究。
