Cullmann W, Schlunegger H
Pharma-Forschung/Infectious Diseases, F. Hoffmann-La Roche AG, Basel.
Immun Infekt. 1993 Feb;21(1):9-12.
Fifty-three clinical Streptococcus pneumoniae isolates from Hungary and Spain which were either moderately susceptible to penicillin G (MIC 0.25-1 mg/l) or highly resistant (MIC > or = 2 mg/l) were studied for their antibacterial susceptibility to the following 14 agents: penicillin G, amoxicillin, mezlocillin, cefotaxime, ceftriaxone, amikacin, cotrimoxazole, erythromycin, rifampicin, vancomycin, fosfomycin, doxycycline, ciprofloxacin, and the dual-action compound Ro 23-9424. Rifampicin was the most active compound (MIC90 < or = 0.015 mg/l) followed by imipenem (MIC90 0.25 mg/l), vancomycin (MIC90 1 mg/l), cefotaxime and ceftriaxone (MIC90 1 mg/l), the dual-action compound Ro 23-9424 and amoxicillin (MIC90 2 mg/l). Most of the isolates were less sensitive to ciprofloxacin (MIC90 4 mg/l), doxycycline and erythromycin (MIC90 16 mg/l) and resistant to cotrimoxazole (MIC90 640 mg/l). Furthermore, synergism between penicillin G or ceftriaxone on the one hand, amikacin or rifampicin on the other hand was studied in all 53 isolates. A combination of a beta-lactam with amikacin resulted mostly in an additive effect, as was the case for the rifampicin combinations. The selection of rifampicin-resistant clones can be repressed by the addition of a beta-lactam thus suggesting such a combination of rifampicin with a beta-lactam as a possible therapeutic approach.
对来自匈牙利和西班牙的53株临床肺炎链球菌分离株进行了研究，这些分离株对青霉素G中度敏感（MIC为0.25 - 1mg/L）或高度耐药（MIC≥2mg/L），检测它们对以下14种药物的抗菌敏感性：青霉素G、阿莫西林、美洛西林、头孢噻肟、头孢曲松、阿米卡星、复方新诺明、红霉素、利福平、万古霉素、磷霉素、强力霉素、环丙沙星以及双效化合物Ro 23 - 9424。利福平是活性最强的化合物（MIC90≤0.015mg/L），其次是亚胺培南（MIC90 0.25mg/L）、万古霉素（MIC90 1mg/L）、头孢噻肟和头孢曲松（MIC90 1mg/L）、双效化合物Ro 23 - 9424和阿莫西林（MIC90 2mg/L）。大多数分离株对环丙沙星（MIC90 4mg/L）、强力霉素和红霉素（MIC90 16mg/L）敏感性较低，对复方新诺明耐药（MIC90 640mg/L）。此外，对所有53株分离株研究了青霉素G或头孢曲松与阿米卡星或利福平之间的协同作用。β-内酰胺类与阿米卡星联合大多产生相加作用，利福平联合用药也是如此。添加β-内酰胺类可抑制耐利福平克隆的选择，因此提示利福平与β-内酰胺类联合可能是一种治疗方法。
