摘要
目的:研究头孢噻肟与阿奇霉素对临床分离的金黄色葡萄球菌、大肠埃希菌及肺炎克雷伯菌的体外联合抗菌效应。方法:采用棋盘法设计,应用微量肉汤稀释法,测定不同浓度组合的抗菌药物分别对3种细菌不同菌株的最低抑茵浓度(MIC).并计算联合抑茵指数(FICI),以及观察两药不同加药顺序对效应的影响。结果:对临床分离金黄色葡萄球菌、大肠埃希菌或肺炎克雷伯菌,头孢噻肟或阿奇霉素的MIC体外联用均比其单独应用有明显降低;联用累积抑菌率有较大提高;两药联用后,对金黄色葡萄球菌协同作用比率为12.5%,相加作用为68.8%,无关作用为18.7%,没有拮抗作用;大肠埃希菌协同作用为17%,相加作用为60%,无关作用为10%.拮抗作用为13%;肺炎克雷伯菌协同作用为20%,相加作用为63%,无关作用为10%,拮抗作用为7%;另外,头孢噻肟与阿奇霉素不同加药顺序对联合药敏无明显影响(P>0.05)。结论:头孢噻肟与阿奇霉素体外联用以相加与协同作用为主,革兰阴性杆菌个别菌株可出现拮抗。
OBJECTIVE To study the antibiotic effects of cefotaxime （CTX） combined with azithromycin（ AZI ）against Staphylococcus aureus,E, coli and Klebsiella pneumoniae from clinical specimens. METHODS The protocol was designed by the checkerboard method and the MICs of CTX combined with AZI used at different against the strains of the three kinds of bacteria were determired, the fractional inhibitory concentration indexes（FICIs） were calculated according to the MICs. The antibiotic effects of the two drugs used at different time were observed. RESULTS The MIC was obviously reduced by applying CTX combined with AZI anginst Staphylococcus aureus, E. coli or Klebsiella pneumoniae separated from clinic in vitro than that of CTX or AZI used alone ;the accumulative antibacterial action rate was enhanced obviously. The percentage of the synergistic action,additive effect, irrelevant action and antagonistic action of CTX combined with AZI against Staphylococcus aureus was 12. 5%,68. 8% ,18. 7%,0% respectively; against E. coli was 17% ,60% ,10%, 13% respectively;and against Klebsieila pneumoniae was 20%,63%, 10%, 7%. There was no marked difference in antibiotic effect between the order of administrations of azithromycin and cefotaxime at the same or different time（P〉0. 05）. CONCLUSION The antibiotic effects of CTX combined with AZI against bacteria from clinical specimens were mostly additive and synergistic. The antagonistic action may be found in a few strains of G- bacilli.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2009年第24期2103-2106,共4页
Chinese Journal of Hospital Pharmacy
基金
常州四药临床药学科研基金[编号:CS2007932]
关键词
头孢噻肟
阿奇霉素
金黄色葡萄球菌
大肠埃希菌
肺炎克雷伯菌
抑菌指数
棋盘法
cefotaxime
azithromycin
Staphylococcus aureus
E. coli
Kebsiella pneumoniae
fractional inhibitory concentration index（FICI）
the checkerboard method
