Husson M O, Fruchart A, Izard D
Laboratoire de Bactériologie-Hygiène, Faculté de Médecine, Lille, France.
Pathol Biol (Paris). 1998 Apr;46(4):279-83.
The aim of this study was to evaluate by a kinetic time-kill method the synergy and bactericidal activity of cefepime and cefpirome in association with vancomycin and teicoplanin against 4 coagulase-positive and 7-negative staphylococci strains. Among these 2 were susceptible to methicillin and 7 resistant. Antibiotic concentrations used for time-kill curves were 0.5 and 1 CMI for glycopeptides and 32 mg/l for cephalosporins. Bactericidal activity was defined as a 3 log10 reduction of the initial inoculum. Cephalosporins at 32 mg/l and teicoplanin at 1 CMI were not bactericidal, while vancomycin at 1 CMI was bactericidal in 24 to 48 h for 3 strains. Cefepime and cefpirome in association with vancomycin were bactericidal against all strains with no secondary regrowth. Bactericidal activity was observed for 6 and 9 strains with the combinations of cefepime-teicoplanin and cefpirome-teicoplanin respectively. In conclusion, despite no significant antistaphylococcal activity of cefepime and cefpirome, their association to glycopeptides improved the bactericidal activity of vancomycin and teicoplanin.
本研究旨在通过动态时间杀菌法评估头孢吡肟和头孢匹罗与万古霉素及替考拉宁联合应用对4株凝固酶阳性葡萄球菌和7株阴性葡萄球菌菌株的协同作用及杀菌活性。其中2株对甲氧西林敏感，7株耐药。用于时间杀菌曲线的抗生素浓度，糖肽类为0.5和1个杀菌浓度指数（CMI），头孢菌素类为32mg/L。杀菌活性定义为初始接种量降低3个对数10。32mg/L的头孢菌素和1个CMI的替考拉宁无杀菌作用，而1个CMI的万古霉素对3株菌株在24至48小时内有杀菌作用。头孢吡肟和头孢匹罗与万古霉素联合应用对所有菌株均有杀菌作用且无二次生长。头孢吡肟 - 替考拉宁和头孢匹罗 - 替考拉宁联合应用分别对6株和9株菌株有杀菌活性。总之，尽管头孢吡肟和头孢匹罗无显著的抗葡萄球菌活性，但它们与糖肽类联合应用可提高万古霉素和替考拉宁的杀菌活性。
