Mortensen J E, Giger O, Rodgers G L
Department of Pediatrics, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Diagn Microbiol Infect Dis. 1998 Feb;30(2):99-102. doi: 10.1016/s0732-8893(97)00209-5.
Pasteurella multocida causes a wide variety of infections and is the most common localized soft tissue infection after animal bite injuries. Penicillin or amoxicillin has been considered agent of choice for therapy. Reported beta-lactamase production by some isolates, the therapeutic dilemma of the penicillin allergic patient, and the polymicrobial nature of some infections led to this study of alternate antimicrobial agents. The in vitro activity of ampicillin, amoxicillin/clavulanate, cefprozil, cefuroxime, erythromycin, clarithromycin, trimethoprim/sulfamethoxazole, ciprofloxacin, and tetracycline were compared to penicillin against 73 geographically diverse isolates of P. multocida from human infections collected since 1991. MIC90 (microgram/mL) were as follows: penicillin < or = 0.06; ampicillin < or = 0.5; amoxicillin/clavulanate < or = 0.5; cefaclor 1.0; cefprozil 1.0; cefpodoxime 0.06; cephalothin 2.5; cefuroxime < or = 0.25; erythromycin 2.0; azithromycin 1.0; clarithromycin 4.0; trimethoprim/sulfamethoxazole < or = 0.5/9.5; ciprofloxacin < or 0.25; tetracycline < or = 2.0. No beta-lactamase producing isolates were found in this study. This in vitro study has identified alternate oral agents to penicillins that may be appropriate for therapy of P. multocida infections.
多杀巴斯德菌可引起多种感染，是动物咬伤后最常见的局部软组织感染病原体。青霉素或阿莫西林一直被认为是治疗的首选药物。由于一些分离株报道可产生β-内酰胺酶、青霉素过敏患者的治疗困境以及一些感染的多微生物性质，导致了对替代抗菌药物的研究。自1991年以来，从人类感染中收集了73株来自不同地理区域的多杀巴斯德菌分离株，将氨苄西林、阿莫西林/克拉维酸、头孢丙烯、头孢呋辛、红霉素、克拉霉素、甲氧苄啶/磺胺甲恶唑、环丙沙星和四环素的体外活性与青霉素进行了比较。MIC90（微克/毫升）如下：青霉素≤0.06；氨苄西林≤0.5；阿莫西林/克拉维酸≤0.5；头孢克洛1.0；头孢丙烯1.0；头孢泊肟0.06；头孢噻吩2.5；头孢呋辛≤0.25；红霉素2.0；阿奇霉素1.0；克拉霉素4.0；甲氧苄啶/磺胺甲恶唑≤0.5/9.5；环丙沙星<或0.25；四环素≤2.0。本研究未发现产β-内酰胺酶的分离株。这项体外研究确定了可替代青霉素的口服药物，可能适用于多杀巴斯德菌感染的治疗。
