Chambers H F, Kartalija M, Sande M
Medical Service, San Francisco General Hospital, CA 94143-0811.
J Infect Dis. 1995 Apr;171(4):897-902. doi: 10.1093/infdis/171.4.897.
Ampicillin or amoxicillin at 625-800 mg/kg/day, in combination with a beta-lactamase inhibitor, each is as effective as vancomycin in animal models of methicillin-resistant Staphylococcus aureus endocarditis. Studies were done to determine whether the addition of rifampin would permit lowering the dose of ampicillin into the range recommended for use in humans without loss of efficacy. The efficacy of ampicillin/sulbactam (300/150 or 150/75 mg/kg/day intramuscularly, in three divided doses) in combination with rifampin (5 mg/kg intramuscularly, three times daily) was compared with that of vancomycin (25 mg/kg intravenously, twice daily, or 30 mg/kg intramuscularly, three times daily) in the rabbit model of methicillin-resistant S. aureus aortic valve endocarditis. Neither ampicillin/sulbactam nor rifampin alone was effective. The ampicillin/sulbactam/rifampin regimen was as effective as vancomycin. This regimen may be an alternative to vancomycin in treatment of methicillin-resistant S. aureus infections.
氨苄西林或阿莫西林剂量为625 - 800毫克/千克/天，并与β-内酰胺酶抑制剂联合使用，在耐甲氧西林金黄色葡萄球菌心内膜炎的动物模型中，其疗效与万古霉素相当。已开展研究以确定添加利福平是否能使氨苄西林剂量降至推荐用于人类的范围内且不影响疗效。在耐甲氧西林金黄色葡萄球菌主动脉瓣心内膜炎的兔模型中，比较了氨苄西林/舒巴坦（300/150或150/75毫克/千克/天，肌内注射，分三次给药）联合利福平（5毫克/千克，肌内注射，每日三次）与万古霉素（25毫克/千克，静脉注射，每日两次，或30毫克/千克，肌内注射，每日三次）的疗效。单独使用氨苄西林/舒巴坦或利福平均无效。氨苄西林/舒巴坦/利福平方案与万古霉素疗效相当。该方案可能是治疗耐甲氧西林金黄色葡萄球菌感染时替代万古霉素的一种选择。
