Hecht D W, Wexler H M
Medical Service, Edward Hines Jr. Veterans Administration, Maywood, Illinois, USA.
Clin Infect Dis. 1996 Dec;23 Suppl 1:S2-8. doi: 10.1093/clinids/23.supplement_1.s2.
The in vitro activity of early fluoroquinolone antibodies--including ciprofloxacin, ofloxacin, fleroxacin, pefloxacin, enoxacin, and lomefloxacin--against most anaerobes has been limited, a characteristic making them poor choices as antianaerobic agents. Newer fluoroquinolones, including levofloxacin, sparfloxacin, and grepafloxacin, have moderate activity against anaerobes, including the Bacteroides fragilis group as well as Clostridium, Peptostreptococcus, Prevotella, and Fusobacterium species. Fluoroquinolones that demonstrate the greatest activity against the B. fragilis group and other anaerobes include DU-6859a, clinafloxacin, and the related naphthyridone, trovafloxacin. There has been wide variation in the susceptibility results among different studies testing the same antibiotic; such variation may be due in part to the use of different methodologies, inoculum sizes, and testing media. In a direct comparison of susceptibility findings for ciprofloxacin, ofloxacin, and levofloxacin in three different media, we have determined that twofold dilution differences in minimum inhibitory concentration (MIC) values (MIC90, mode MIC, and geometric mean MIC) may occur in association with the choice of testing media. Thus, testing media should be considered when comparing results of different studies on the susceptibility of anaerobes to fluoroquinolones.
早期氟喹诺酮类抗生素——包括环丙沙星、氧氟沙星、氟罗沙星、培氟沙星、依诺沙星和洛美沙星——对大多数厌氧菌的体外活性有限，这一特性使其作为抗厌氧菌药物并非理想选择。新型氟喹诺酮类药物，包括左氧氟沙星、司帕沙星和格帕沙星，对厌氧菌具有中等活性，这些厌氧菌包括脆弱拟杆菌属以及梭菌属、消化链球菌属、普雷沃菌属和梭杆菌属。对脆弱拟杆菌属和其他厌氧菌显示出最大活性的氟喹诺酮类药物包括DU - 6859a、克林沙星以及相关的萘啶酮类药物曲伐沙星。在对同一种抗生素进行测试的不同研究中，药敏结果存在很大差异；这种差异可能部分归因于使用了不同的方法、接种量和测试培养基。在对环丙沙星、氧氟沙星和左氧氟沙星在三种不同培养基中的药敏结果进行直接比较时，我们确定，与测试培养基的选择相关，最低抑菌浓度（MIC）值（MIC90、模式MIC和几何平均MIC）可能会出现两倍的稀释差异。因此，在比较不同研究中厌氧菌对氟喹诺酮类药物药敏结果时，应考虑测试培养基。
