Thornsberry C, Ogilvie P T, Holley H P, Sahm D F
MRL Pharmaceutical Services, Brentwood, Tennessee 37027, USA.
Clin Ther. 1998 Nov-Dec;20(6):1179-90. doi: 10.1016/s0149-2918(98)80113-6.
Strains of Streptococcus pneumoniae from the United States that were susceptible, intermediately resistant, or highly resistant to penicillin were tested for susceptibility to 26 antimicrobial agents that have been used or considered for the treatment of patients with pneumococcal infections. The drugs tested included penicillins, one penicillin/beta-lactamase inhibitor combination, cephalosporins, macrolides, a lincosamide, fluoroquinolones, and four miscellaneous drugs (vancomycin, rifampin, tetracycline, and trimethoprim-sulfamethoxazole). The activities of the penicillins and macrolide agents were similar, but the activities within the cephalosporin and fluoroquinolone classes were often dissimilar. For the fluoroquinolones, the order of in vitro activity, from most to least active, was grepafloxacin, sparfloxacin, levofloxacin, ciprofloxacin, and ofloxacin. Increased resistance to penicillin in the pneumococcal isolates studied correlated with increased resistance to other penicillins, cephalosporins, macrolides, clindamycin, tetracycline, and trimethoprim-sulfamethoxazole but did not correlate with increased resistance to the fluoroquinolones, rifampin, or vancomycin. These findings may be helpful to health professionals selecting empiric therapy for respiratory tract infections involving S. pneumoniae.
对来自美国的对青霉素敏感、中度耐药或高度耐药的肺炎链球菌菌株，检测了它们对26种已用于或被考虑用于治疗肺炎球菌感染患者的抗菌药物的敏感性。所检测的药物包括青霉素类、一种青霉素/β-内酰胺酶抑制剂组合、头孢菌素类、大环内酯类、一种林可酰胺类、氟喹诺酮类以及四种其他药物（万古霉素、利福平、四环素和甲氧苄啶-磺胺甲恶唑）。青霉素类和大环内酯类药物的活性相似，但头孢菌素类和氟喹诺酮类药物的活性通常不同。对于氟喹诺酮类药物，体外活性从高到低的顺序为格帕沙星、司帕沙星、左氧氟沙星、环丙沙星和氧氟沙星。在所研究的肺炎球菌分离株中，对青霉素耐药性的增加与对其他青霉素类、头孢菌素类、大环内酯类、克林霉素、四环素和甲氧苄啶-磺胺甲恶唑耐药性的增加相关，但与对氟喹诺酮类、利福平或万古霉素耐药性的增加无关。这些发现可能有助于卫生专业人员为涉及肺炎链球菌的呼吸道感染选择经验性治疗方案。
