Rouse M S, Steckelberg J M, Brandt C M, Patel R, Miro J M, Wilson W R
Infectious Diseases Research Laboratory, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Antimicrob Agents Chemother. 1997 Aug;41(8):1673-6. doi: 10.1128/AAC.41.8.1673.
The efficacy of azithromycin or clarithromycin was compared to that of amoxicillin, clindamycin, or erythromycin for the prevention of viridans group streptococcus experimental endocarditis. Rabbits with catheter-induced aortic valve vegetations were given no antibiotics or two doses of amoxicillin at 25 mg/kg of body weight, azithromycin at 10 mg/kg, clarithromycin at 10 mg/kg, clindamycin at 40 mg/kg followed by clindamycin at 20 mg/kg, or erythromycin at 10 mg/kg. Antibiotics were administered 0.5 h before and 5.5 h after intravenous infusion of 5 x 10(5) CFU of Streptococcus milleri. Forty-eight hours after bacterial inoculation, the rabbits were killed and aortic valve vegetations were aseptically removed and cultured for bacteria. Infective endocarditis occurred in 88% of untreated animals, 1% of animals receiving amoxicillin, 9% of animals receiving erythromycin, 0% of animals receiving clindamycin, 2.5% of animals receiving clarithromycin, and 1% of animals receiving azithromycin. All five regimens were more effective (P < 0.001) than no prophylaxis. Erythromycin was less effective (P < 0.05) than amoxicillin or clindamycin. Azithromycin or clarithromycin was as effective as amoxicillin, clindamycin, or erythromycin for the prevention of viridans group streptococcus experimental endocarditis in this model.
将阿奇霉素或克拉霉素的疗效与阿莫西林、克林霉素或红霉素预防草绿色链球菌实验性心内膜炎的疗效进行了比较。对有导管诱导的主动脉瓣赘生物的兔子不给予抗生素，或给予两剂体重25mg/kg的阿莫西林、10mg/kg的阿奇霉素、10mg/kg的克拉霉素、40mg/kg随后20mg/kg的克林霉素，或10mg/kg的红霉素。在静脉输注5×10(5)CFU米勒链球菌前0.5小时和后5.5小时给予抗生素。细菌接种48小时后，处死兔子，无菌取出主动脉瓣赘生物并进行细菌培养。88%的未治疗动物发生感染性心内膜炎，接受阿莫西林的动物中有1%、接受红霉素的动物中有9%、接受克林霉素的动物中有0%、接受克拉霉素的动物中有2.5%、接受阿奇霉素的动物中有1%发生感染性心内膜炎。所有五种方案都比不进行预防更有效（P<0.001）。红霉素的效果不如阿莫西林或克林霉素（P<0.05）。在该模型中，阿奇霉素或克拉霉素在预防草绿色链球菌实验性心内膜炎方面与阿莫西林、克林霉素或红霉素效果相当。
