Dubrous P, Cavallo J D, Hernandez E, Nordmann P, Fabre R
Service de Biologie Médicale, HIA Bégin, Saint-Mandé, France.
Pathol Biol (Paris). 1997 May;45(5):433-7.
Bactericidal activities of 8 antibiotics (ticarcillin, piperacillin, piperacillin-tazobactam, ceftazidime, cefepime, imipenem, amikacin, ciprofloxacin) and of 7 combinations have been studied by time-killing curve technique for 16 Pseudomonas aeruginosa selected for their beta-lactams resistance phenotypes (3 wild strains, 5 penicillinases, 2 extended-spectrum beta-lactamases, 3 high level cephalosporinases and 3 non enzymatic resistance). Bactericidal activities of beta-lactams used alone were as follows: imipenem > cefepime > ceftazidime, piperacillin, piperacillin-tazobactam > ticarcillin. All the antibiotics combinations were synergistic or additive. However, only the combination of imipenem with amikacin was bactericidal for all strains. For the strains with penicillinases, piperacillin-tazobactam was not more effective than piperacillin. For the extended-spectrum beta-lactamases, we have observed a synergy with piperacillin-tazobactam and ciprofloxacin or amikacin.
采用时间杀菌曲线技术，对8种抗生素（替卡西林、哌拉西林、哌拉西林-他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、阿米卡星、环丙沙星）以及7种联合用药方案对16株铜绿假单胞菌的杀菌活性进行了研究。这些菌株根据其β-内酰胺类耐药表型进行选择（3株野生型菌株、5株青霉素酶产生菌、2株超广谱β-内酰胺酶产生菌、3株高产头孢菌素酶菌株和3株非酶耐药菌株）。单独使用β-内酰胺类抗生素的杀菌活性如下：亚胺培南＞头孢吡肟＞头孢他啶、哌拉西林、哌拉西林-他唑巴坦＞替卡西林。所有抗生素联合用药方案均具有协同或相加作用。然而，只有亚胺培南与阿米卡星的联合用药方案对所有菌株均有杀菌作用。对于产青霉素酶的菌株，哌拉西林-他唑巴坦并不比哌拉西林更有效。对于产超广谱β-内酰胺酶的菌株，我们观察到哌拉西林-他唑巴坦与环丙沙星或阿米卡星联合用药具有协同作用。
