Synergistic effect of quinolones and oxacillin on methicillin-resistant Staphylococcus species
Synergistic effect of quinolones and oxacillin on methicillin-resistant Staphylococcus species
复制标题
喹诺酮类药物和苯唑西林对耐甲氧西林葡萄球菌的协同作用
DOI：
--
复制
发表时间：
1989
影响因子：
4.9
通讯作者：
D. Lew
中科院分区：
文献类型：
--
作者：
P. Rohner;C. Herter;R. Auckenthaler;J. Pechère;F. Waldvogel;D. Lew
抗葡萄球菌抗菌药物的各种组合已经针对17种选定的葡萄球菌分离株进行了测试，包括甲氧西林敏感和甲氧西林耐药的葡萄球菌菌株。金黄色葡萄球菌和凝固酶阴性葡萄球菌。采用棋盘技术测试了以下组合：苯唑西林-氧氟沙星、苯唑西林-替马氟沙星、苯唑西林-氟罗沙星、万古霉素-氟罗沙星、庆大霉素-氟罗沙星和利福平-氟罗沙星。针对耐甲氧西林葡萄球菌，在35 ℃下测试的苯唑西林-喹诺酮组合总是显示小于0.75的部分抑制浓度（FIC）指数，这被解释为协同或相加。在30 ℃下观察到相等或更大的协同效应。相反，当检测甲氧西林敏感葡萄球菌属时，苯唑西林-喹诺酮组合的FIC始终为1或2，这被认为是无关紧要的。对于其他提到的组合，FIC也是1或2。杀菌动力学显示，苯唑西林-氧氟沙星组合对耐甲氧西林葡萄球菌属具有协同或相加杀菌活性，孵育24小时后，每毫升比最具活性的药物多杀死1.5至2.8 log 10 CFU。甲氧西林敏感菌株未观察到这种差异。提供了喹诺酮类药物与β-内酰胺酶耐药青霉素联合治疗耐甲氧西林葡萄球菌感染的潜在临床应用的体外证据。
Various combinations of antistaphylococcal antimicrobial agents have been tested against 17 selected Staphylococcus isolates, including methicillin-susceptible and methicillin-resistant strains of S. aureus and coagulase-negative Staphylococcus species. With the checkerboard technique the following combinations were tested: oxacillin-ofloxacin, oxacillin-temafloxacin, oxacillin-fleroxacin, vancomycin-fleroxacin, gentamicin-fleroxacin, and rifampin-fleroxacin. Against methicillin-resistant staphylococci the combination oxacillin-quinolone tested at 35 degrees C always showed a fractional inhibitory concentration (FIC) index of less than 0.75, which is interpreted as synergistic or additive. Equal or more synergistic effects were observed at 30 degrees C. In contrast, when methicillin-susceptible Staphylococcus species were tested, the FIC for the combination oxacillin-quinolone was always 1 or 2, which is considered to be indifferent. For the other mentioned combinations the FICs were also 1 or 2. Killing kinetics showed synergistic or additive bactericidal activity for the combination oxacillin-ofloxacin against methicillin-resistant Staphylococcus species, killing 1.5 to 2.8 log10 CFU more of these per ml than did the most active drug after 24 h of incubation. This difference was not observed for methicillin-susceptible strains. In vitro evidence for the potential clinical use of quinolones in treating infections due to methicillin-resistant staphylococci in combination with a beta-lactamase-resistant penicillin is provided.