Deguchi K, Yokota N, Koguchi M, Suzuki Y, Fukayama S, Ishihara R, Oda S, Tanaka S, Nakane Y, Fukumoto T
Section of Studies, Tokyo Clinical Research Center.
Jpn J Antibiot. 1994 Apr;47(4):365-82.
Antimicrobial activity of cefuroxime axetil (CXM-AX) was compared with those of other cephem antibiotics against clinically isolated strains obtained mainly from outpatients of our center in a period from January to September of 1990 and 1993. Minimum inhibitory concentrations were determined and the following results were obtained. 1. The results suggested that, compared with reports of studies conducted with clinical isolates in early 1980's, MIC80 of CXM were equal to or lower against Staphylococcus spp., Streptococcus pyogenes, Escherichia coli, Klebsiella spp., Proteus mirabilis, Haemophilus influenzae, Moraxella subgenus Branhamella catarrhalis, Neisseria gonorrhoeae, Peptostreptococcus spp., and Propionibacterium acnes, except for Streptococcus pneumoniae, MIC80 which was slightly higher. 2. MIC90 of comparator drugs reflected those of new resistant organisms recently appeared, such as benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP), cephem-resistant E. coli and Klebsiella spp., new quinolone-resistant H. influenzae and N. gonorrhoeae. Methicillin-resistant Staphylococcus aureus (MRSA) was detected also from specimens of community acquired infections. From the nature of MRSA detected in those situations MRSA appeared to present a continuing problem. 3. MIC90 against strains obtained from patients with community acquired infections was a good index of increases of multidrug-resistant organisms in the past. Therefore, the determination of MIC90 is important in examining changes with time of sensitivities or resistances of clinically isolated strains to antimicrobial drugs. 4. Antimicrobial activities of CXM against recent clinical isolates showed the existence of problems as mentioned above. However, MIC of CXM as well as those of comparator drugs indicated that antimicrobial activities of CXM against Staphylococcus spp., Streptococcus spp., H. influenzae appeared to be relatively strong, and it is concluded that cefuroxime axetil still is one of the clinically useful oral antimicrobial drugs in the 1990's.
将头孢呋辛酯(CXM-AX)与其他头孢菌素类抗生素对1990年1月至9月以及1993年期间主要从本中心门诊患者分离得到的临床菌株的抗菌活性进行了比较。测定了最低抑菌浓度,结果如下:1. 结果表明,与20世纪80年代初对临床分离株进行的研究报告相比,除肺炎链球菌的MIC80略高外,CXM对葡萄球菌属、化脓性链球菌、大肠埃希菌、克雷伯菌属、奇异变形杆菌、流感嗜血杆菌、莫拉菌属(卡他布兰汉菌)、淋病奈瑟菌、消化链球菌属和痤疮丙酸杆菌的MIC80相等或更低。2. 对照药物的MIC90反映了最近出现的新耐药菌的情况,如对苄星青霉素(PCG)不敏感的肺炎链球菌(PISP)、对头孢菌素耐药的大肠埃希菌和克雷伯菌属、对新喹诺酮耐药的流感嗜血杆菌和淋病奈瑟菌。在社区获得性感染的标本中也检测到了耐甲氧西林金黄色葡萄球菌(MRSA)。从这些情况下检测到的MRSA的性质来看,MRSA似乎是一个持续存在的问题。3. 对社区获得性感染患者分离菌株的MIC90是过去多药耐药菌增加的一个良好指标。因此,测定MIC90对于检查临床分离株对抗菌药物的敏感性或耐药性随时间的变化很重要。4. CXM对近期临床分离株的抗菌活性存在上述问题。然而,CXM以及对照药物的MIC表明,CXM对葡萄球菌属、链球菌属、流感嗜血杆菌的抗菌活性似乎相对较强,得出结论,头孢呋辛酯在20世纪90年代仍然是临床上有用的口服抗菌药物之一。