Brook I, Gilmore J D
Naval Medical Research Institute, Bethesda, Maryland 20814-5055.
Antimicrob Agents Chemother. 1993 Jul;37(7):1452-5. doi: 10.1128/AAC.37.7.1452.
The in vivo effects of penicillin and cefprozil therapy on the interaction between organisms commonly recovered from inflamed tonsils were studied by using a subcutaneous abscess model in mice. These organisms were group A beta-hemolytic streptococci (GABHS), Streptococcus salivarius (which is capable of interfering with GABHS), and Staphylococcus aureus. In mice infected with GABHS and S. salivarius alone or in combination, penicillin eliminated both organisms and cefprozil eliminated GABHS and S. aureus but not S. salivarius. Penicillin did not, however, reduce the number of GABHS or S. salivarius in the presence of S. aureus. The present study demonstrated the ability of beta-lactamase-producing S. aureus to protect GABHS from penicillin. However, no such protection was present following the administration of cefprozil. Furthermore, the preservation of S. salivarius that interferes with GABHS growth may provide protection from reinfection with GABHS. This study supports and provides an explanation for the increased efficacies of cephalosporins administered orally over that of penicillin when treating patients with acute GABHS pharyngitis or tonsillitis.
通过在小鼠中使用皮下脓肿模型，研究了青霉素和头孢丙烯疗法对从发炎扁桃体中常见分离出的微生物之间相互作用的体内影响。这些微生物为A组β溶血性链球菌（GABHS）、唾液链球菌（能够干扰GABHS）和金黄色葡萄球菌。在单独或联合感染GABHS和唾液链球菌的小鼠中，青霉素清除了这两种微生物，头孢丙烯清除了GABHS和金黄色葡萄球菌，但未清除唾液链球菌。然而，在存在金黄色葡萄球菌的情况下，青霉素并未减少GABHS或唾液链球菌的数量。本研究证明了产β-内酰胺酶的金黄色葡萄球菌能够保护GABHS免受青霉素的影响。然而，给予头孢丙烯后不存在这种保护作用。此外，干扰GABHS生长的唾液链球菌的留存可能提供对GABHS再感染的保护。本研究支持并解释了在治疗急性GABHS咽炎或扁桃体炎患者时，口服头孢菌素比青霉素疗效更高的原因。
