Chen C H, Yang M H, Lin J S, Lee Y C, Perng R P
Department of Chest Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Proc Natl Sci Counc Repub China B. 1995 Apr;19(2):80-4.
Although there are reports that the addition of a beta-lactamase inhibitor to ampicillin or amoxicillin greatly improves their in vitro activity against M. tuberculosis, there are no written reports about the antituberculosis effects of beta-lactamase inhibitors in combination with cephalosporins against M. tuberculosis. In this report, we have determined the minimal inhibitory concentrations (MIC) of 5 cephalosporins with or without combination with beta-lactamase inhibitor against M. tuberculosis strains isolated from patients before antituberculosis treatment and checked the production of beta-lactamase by bacteria before this procedure. Four strains of M. tuberculosis were contaminated during the experiment, and all the other 16 strains hydrolyzed the nitrocefin disc, thus indicating a beta-lactamase producer. The MICs of cephalosporins alone against M. tuberculosis were 200-400 micrograms/ml for ceforanide, 100-400 micrograms/ml for cephapirin, 400-1600 micrograms/ml for cefamandole, 200-1600 micrograms/ml for cefotaxime, and 800-1600 micrograms/ml for ceftriaxone. After adding the equimolar concentrations of sulbactam, the MICs were reduced to 100-200 micrograms/ml for ceforanide, 12.5-100 micrograms/ml for cephapirin, 100-400 micrograms/ml for cefamandole, 25-200 micrograms/ml for cefotaxime, and 100-800 micrograms/ml for ceftriaxone. We concluded that sulbactam enhanced the antituberculosis effect of cephalosporins.
虽然有报道称，在氨苄西林或阿莫西林中添加β-内酰胺酶抑制剂可大大提高其对结核分枝杆菌的体外活性，但尚无关于β-内酰胺酶抑制剂与头孢菌素联合对结核分枝杆菌抗结核作用的书面报道。在本报告中，我们测定了5种头孢菌素单独或与β-内酰胺酶抑制剂联合使用时，对结核治疗前从患者分离出的结核分枝杆菌菌株的最低抑菌浓度（MIC），并在此过程之前检测了细菌β-内酰胺酶的产生。实验期间有4株结核分枝杆菌被污染，其他16株均水解了硝基头孢菌素纸片，表明它们是β-内酰胺酶产生菌。头孢菌素单独对结核分枝杆菌的MIC分别为：头孢乙腈200 - 400微克/毫升，头孢匹林100 - 400微克/毫升，头孢孟多400 - 1600微克/毫升，头孢噻肟200 - 1600微克/毫升，头孢曲松800 - 1600微克/毫升。加入等摩尔浓度的舒巴坦后，头孢乙腈的MIC降至100 - 200微克/毫升，头孢匹林降至12.5 - 100微克/毫升，头孢孟多降至100 - 400微克/毫升，头孢噻肟降至25 - 200微克/毫升，头孢曲松降至100 - 800微克/毫升。我们得出结论，舒巴坦增强了头孢菌素的抗结核作用。
