Neu H C
Division of Infectious Diseases, College of Physicians and Surgeons, Columbia University, New York.
Drugs. 1993;45 Suppl 3:54-8. doi: 10.2165/00003495-199300453-00011.
In an attempt to overcome some of the gaps in their antibacterial spectrum, e.g. some Gram-positive bacteria (notably streptococci and Streptococcus pneumoniae) and anaerobes, the fluoroquinolones have been combined with other bactericidal and bacteriostatic agents. In general, the fluoroquinolones rarely show either synergy or antagonism when used in combination with other antimicrobial agents against most bacteria. Therefore, in infections where the fluoroquinolones do not provide cover against all potential organisms, combined treatment with an appropriate agent may be considered. Current data suggest that the fluoroquinolones are not antagonistic with beta-lactams, macrolides, clindamycin and the imidazoles. Aminoglycosides in combination with the fluoroquinolones do not show synergy. Antipseudomonal penicillins, ceftazidime or imipenem in combination with the fluoroquinolones are synergistic and may be useful for treating infections in immunocompromised patients. Rifampicin in combination with a fluoroquinolone for the treatment of staphylococcal endocarditis or osteomyelitis may be useful, although in vitro and in vivo results do not always coincide.
为了克服氟喹诺酮类药物抗菌谱中的一些不足，例如对某些革兰氏阳性菌（特别是链球菌和肺炎链球菌）以及厌氧菌的抗菌效果欠佳，人们将氟喹诺酮类药物与其他杀菌和抑菌剂联合使用。总体而言，氟喹诺酮类药物与其他抗菌药物联合用于大多数细菌感染时，很少表现出协同作用或拮抗作用。因此，在氟喹诺酮类药物不能覆盖所有潜在病原体的感染中，可以考虑联合使用适当的药物进行治疗。目前的数据表明，氟喹诺酮类药物与β-内酰胺类、大环内酯类、克林霉素和咪唑类药物不存在拮抗作用。氟喹诺酮类药物与氨基糖苷类药物联合使用时不显示协同作用。抗假单胞菌青霉素、头孢他啶或亚胺培南与氟喹诺酮类药物联合使用具有协同作用，可能有助于治疗免疫功能低下患者的感染。利福平与氟喹诺酮类药物联合用于治疗葡萄球菌性心内膜炎或骨髓炎可能有效，尽管体外和体内实验结果并不总是一致。
