Matoba A Y, Lee B L, Robinson N M, Penland R, Osato M S
Houston Veterans Affair Medical Center, Baylor College of Medicine, Houston, Texas.
Invest Ophthalmol Vis Sci. 1993 Aug;34(9):2786-9.
Medical therapy of Mycobacterium chelonae keratitis is difficult because there are so few effective antimicrobial agents and single agent therapy frequently fails clinically. To identify more effective medical treatment regimens, the in vitro antimicrobial efficacy of amikacin, the most frequently used single agent, was investigated in combination with four antibiotics previously reported to have activity against M. chelonae: erythromycin, imipenem, ciprofloxacin, and vancomycin.
The drug combinations were tested by the checkerboard method against seven corneal isolates of M. chelonae.
The combination of amikacin with erythromycin or vancomycin consistently led to synergistic or additive effect, however the minimum inhibitory concentrations for vancomycin were very high. The combination of amikacin with imipenem or ciprofloxacin led to results ranging from antagonism to additive effects.
Of the antibiotics tested, erythromycin showed the most activity against M. chelonae in combination with amikacin. In vitro combination drug testing of M. chelonae by the checkerboard method should be further evaluated for clinical relevance in microbial keratitis.
龟分枝杆菌角膜炎的药物治疗困难，因为有效的抗菌药物很少，单药治疗在临床上常常失败。为了确定更有效的药物治疗方案，研究了最常用的单药阿米卡星与先前报道的对龟分枝杆菌有活性的四种抗生素联合使用时的体外抗菌效果，这四种抗生素分别是红霉素、亚胺培南、环丙沙星和万古霉素。
采用棋盘法对七株龟分枝杆菌角膜分离株进行药物联合测试。
阿米卡星与红霉素或万古霉素联合使用始终产生协同或相加效应，然而万古霉素的最低抑菌浓度非常高。阿米卡星与亚胺培南或环丙沙星联合使用的结果从拮抗到相加效应不等。
在所测试的抗生素中，红霉素与阿米卡星联合使用时对龟分枝杆菌显示出最强活性。棋盘法对龟分枝杆菌进行体外联合药物测试在微生物性角膜炎中的临床相关性应进一步评估。
