硫酸新霉素、杆菌肽和硫酸多粘菌素B的体外相互作用。

In vitro interactions of neomycin sulfate, bacitracin, and polymyxin B sulfate.

作者信息

Booth J H, Benrimoj S I, Nimmo G R

机构信息

Department of Pharmacy, University of Sydney, New South Wales, Australia.

出版信息

Int J Dermatol. 1994 Jul;33(7):517-20. doi: 10.1111/j.1365-4362.1994.tb02872.x.

DOI:10.1111/j.1365-4362.1994.tb02872.x

PMID:7928043

Abstract

BACKGROUND

Neomycin sulfate, bacitracin, and polymyxin B sulfate have been combined in topical preparations to provide a complementary antimicrobial spectrum for the prevention of minor wound infections. The advisability of the inclusion of neomycin sulfate has been questioned since it may cause contact sensitization.

METHODS

To assess the value of neomycin, microdilution checkerboard titrations were used to determine the in vitro interactions between two-antibiotic and three-antibiotic combinations against reference strains of bacteria commonly associated with wound infections. Using Fractional Inhibitory Concentration (FIC) indices (< 0.5 indicates synergism with two-drug combinations), the combination of neomycin/bacitracin was synergistic for both S. aureus and Ps. aeruginosa; neomycin/polymyxin B was synergistic for E. faecalis, and the bacitracin/polymyxin B combination was synergistic against Ps. aeruginosa. A three-drug combination of neomycin/bacitracin/polymyxin B had FIC values of < 1 for all organisms, indicating synergy and substantiating the clinical role of neomycin sulfate in current topical formulations.

RESULTS

Neomycin has the lowest safety profile of the drugs in this combination. A replacement agent should ideally have similar or superior synergistic capabilities with the remaining drugs and contribute to the therapeutic efficacy of the preparation. Additionally, because of the strongly synergistic tendencies displayed by the three-drug combination, it may be possible to reduce the antibiotic concentrations present in current formulations.

CONCLUSION

By developing this concept, there is potential for the formulation of topical preparations to be based on a sound theoretical and clinical rationale.

摘要

背景

硫酸新霉素、杆菌肽和硫酸多粘菌素B已被联合用于局部制剂中，以提供互补的抗菌谱，预防轻微伤口感染。由于硫酸新霉素可能会引起接触致敏，其是否适宜包含在制剂中受到了质疑。

方法

为评估新霉素的价值，采用微量稀释棋盘滴定法来确定两种抗生素和三种抗生素组合对常见伤口感染相关细菌参考菌株的体外相互作用。使用分数抑菌浓度（FIC）指数（<0.5表明两药组合具有协同作用），新霉素/杆菌肽组合对金黄色葡萄球菌和铜绿假单胞菌均具有协同作用；新霉素/多粘菌素B对粪肠球菌具有协同作用，杆菌肽/多粘菌素B组合对铜绿假单胞菌具有协同作用。新霉素/杆菌肽/多粘菌素B的三药组合对所有菌株的FIC值均<1，表明具有协同作用，并证实了硫酸新霉素在当前局部制剂中的临床作用。