Brook I
Naval Medical Research Institute, Chevy Chase, Maryland 20813-0412.
J Antimicrob Chemother. 1994 Nov;34(5):791-6. doi: 10.1093/jac/34.5.791.
The comparative efficacies of cefoxitin, cefotetan and the combination of ampicillin with sulbactam were investigated in mixed aerobic and anaerobic infections of mice. Treatment was administered by intramuscular injection for 10 days and was started 1 h before infection. After intraperitoneal infection with Escherichia coli, Bacteroides fragilis, and one other member of the B. fragilis group (either Bacteroides thetaiotaomicron, Bacteroides ovatus or Bacteroides distasonis), 41 of 90 (46%) control mice died and all survivors developed polymicrobial abscesses. Cephalosporin therapy reduced mortaligy 13% with cefoxitin, 3% with cefotetan, and 23% with ampicillin plus sulbactam; 14%, 10% and 14% of surviving animals, respectively developed abscesses. Each of the treatment regimens significantly reduced the number of all organisms in abscesses, independent of their activity in vitro. However, the reduction in the number of E. coli by ampicillin plus sulbactam was less marked (P < 0.001) than that achieved by cefoxitin (P < 0.05) or cefotetan. These data show that in vivo efficiencies of cefoxitin and cefotetan, are independent of their in vitro potencies in the early management of polymicrobial infections in mice.
在小鼠需氧菌与厌氧菌混合感染中，研究了头孢西丁、头孢替坦以及氨苄西林与舒巴坦联合用药的相对疗效。治疗通过肌肉注射给药，持续10天，在感染前1小时开始。腹腔注射大肠杆菌、脆弱拟杆菌以及脆弱拟杆菌属的另一种菌（要么是多形拟杆菌、卵形拟杆菌，要么是狄氏拟杆菌）后，90只对照小鼠中有41只（46%）死亡，所有存活小鼠均形成了多种微生物脓肿。头孢菌素治疗使死亡率降低，头孢西丁降低了13%，头孢替坦降低了3%，氨苄西林加舒巴坦降低了23%；存活动物中分别有14%、10%和14%形成了脓肿。每种治疗方案均显著减少了脓肿中所有微生物的数量，与它们的体外活性无关。然而，氨苄西林加舒巴坦对大肠杆菌数量的减少不如头孢西丁（P < 0.05）或头孢替坦显著（P < 0.001）。这些数据表明，在小鼠多种微生物感染的早期治疗中，头孢西丁和头孢替坦的体内疗效与其体外效力无关。
