左氧氟沙星联合万古霉素缩小金黄色葡萄球菌耐药突变选择窗的初步研究  

Preliminary study for narrowing mutant selection window of staphylococcus aureus by combination of levofloxacin and Vancomycin in vitro

作　　者：李朝霞[1] 刘又宁[1] 王睿[2] 童卫杭[2] 程仕虎[1] 

机构地区：[1]解放军总医院呼吸内科,北京100853 [2]解放军总医院临床药理研究室,北京100853

出　　处：《中国临床药理学与治疗学》2007年第8期911-914,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:在体外初步探讨联合用药可缩小单药对细菌的耐药突变选择窗(MSW),为临床合理使用现有抗菌药物,防止细菌耐药产生提供理论依据。方法:应用肉汤法富集1010CFU/mL细菌,琼脂平板二倍稀释法测定左氧氟沙星、万古霉素单药和两药联用对金黄色葡萄球菌ATCC29213的最低药物浓度(MPC)和MSW。结果:左氧氟沙星、万古霉素单药对金黄色葡萄球菌ATCC29213的MSW分别为16和64。万古霉素和左氧氟沙星联合用药(1MIC+8MIC,2MIC+4MIC)使左氧氟沙星单药对ATCC29213的MSW缩小2～4倍。左氧氟沙星联合万古霉素用药(1MIC+16MIC,2MIC+8MIC)使万古霉素对ATCC29213的MSW缩小4～8倍。结论:万古霉素和左氧氟沙星联合用药可缩小各自单药对金黄色葡萄球菌ATCC29213的MSW。AIM： To study whether levofloxacin and Vancomycin combination can narrow mutant selection window（MSW） of single drug group in vitro, which contribute to new strategies for restricting the development of resistance and provide data for rational applications of available antibacterial drugs in clinic practice. METHODS： Minimal antibiotic concentration（MPC） and MSWs were determined by spreading 10^10 CFU/mL coccus on agar plates at different drug concentrations. MPC was defined as the lowest concentration inhibiting 100% of the coccus population after 72 h incubation. RESULTS： MSW of levofloxacin and vancomycin for staphylococcus aureus strain ATCC29213 was 16 and 64 respectively; Vancomy-cin combined with levofloxacin（ 1MIC ＋ 8MIC, 2MIC ＋ 4MIC） decreased the MSW of levofloxacin to staphylococcus aureus ATCC29213 for 2-4 times; Levofloxacin combined with vancomycin （1MIC ＋ 16MIC, 2MIC ＋ 8MIC） decreased the MSW of vancomycin to staphylococcus aureus ATCC29213 for 4 - 8 times. CONCLUSION： Combinations of levofloxacin and vancomycin can decrease MSW to staphylococcus aureus, ATCC29213 compared with individual drug administration.

关 键 词：左氧氟沙星 万古霉素 金黄色葡萄球菌 耐药突变选择窗 

分 类 号：R965.1[医药卫生—药理学]