Hu F R, Wang I J
Department of Ophthalmology, National Taiwan University Hospital, Taipei.
Curr Eye Res. 1998 May;17(5):478-82. doi: 10.1076/ceyr.17.5.478.5195.
To investigate the effect of topical amikacin (25 mg/ml), imipenem (25 mg/ml), ciprofloxacin (3 mg/ml), clarithromycin (20 mg/ml), amikacin combined with ciprofloxacin, amikacin combined with imipenem, and amikacin combined with clarithromycin on Mycobacterium chelonae keratitis.
Ninety New Zealand albino rabbits were infected with a strain of M. chelonae for which minimum inhibitory concentration indicated in vitro sensitivity to the above antibiotics. The rabbits were treated for one or two weeks. The treatment efficacy was judged by the size of stromal infiltrate and quantitative culture of the infected corneas.
The size of the stromal infiltrate showed no significant difference in treated eyes compared to the untreated, control eyes. However, all treatments significantly reduced the number of organisms in treated eyes compared to untreated, control eyes (all p-values < 0.05). No significant difference in treatment efficacy was found between individual treatment groups. In none of the cases were organisms eliminated from the infected eyes, even after 2 weeks of treatment.
The results suggest that topical amikacin, imipenem, ciprofloxacin and clarithromycin had some therapeutic effect on M. chelonae keratitis; however, amikacin combined with imipenem, ciprofloxacin, and clarithromycin showed no increased efficacy over single agent therapy during 2 weeks of treatment. Long term treatment may be required to eradicate M. chelonae.
研究局部应用阿米卡星（25毫克/毫升）、亚胺培南（25毫克/毫升）、环丙沙星（3毫克/毫升）、克拉霉素（20毫克/毫升）、阿米卡星联合环丙沙星、阿米卡星联合亚胺培南以及阿米卡星联合克拉霉素对龟分枝杆菌角膜炎的影响。
90只新西兰白兔感染了一株龟分枝杆菌，该菌株的最低抑菌浓度表明其对上述抗生素具有体外敏感性。对这些兔子进行为期一或两周的治疗。通过基质浸润的大小和感染角膜的定量培养来判断治疗效果。
与未治疗的对照眼相比，治疗眼的基质浸润大小无显著差异。然而，与未治疗的对照眼相比，所有治疗均显著减少了治疗眼中的细菌数量（所有p值<0.05）。各治疗组之间在治疗效果上未发现显著差异。即使经过2周的治疗，感染眼中的细菌也未被清除。
结果表明，局部应用阿米卡星、亚胺培南、环丙沙星和克拉霉素对龟分枝杆菌角膜炎有一定治疗作用；然而，在2周的治疗期间，阿米卡星联合亚胺培南、环丙沙星和克拉霉素并未显示出比单一药物治疗更高的疗效。可能需要长期治疗以根除龟分枝杆菌。
