安妥沙星琼脂稀释法体外抗菌活性测定临界浓度初步研究  

A primary study of antofloxaicn breakpoints for agar-dilution sensitivity test

作　　者：肖永红[1] 李耘[1] 刘健[1] 钟巍[1] 杨维维[1] 

机构地区：[1]北京大学第一医院临床药理研究所,北京100083

出　　处：《中国抗生素杂志》2010年第6期462-468,共7页Chinese Journal of Antibiotics

摘　　要：目的确定安妥沙星对葡萄球菌属、肠杆菌科、非发酵菌及嗜血菌属的琼脂稀释法体外抗菌活性测定临界浓度。方法采用标准琼脂二倍稀释法测定安妥沙星对临床常见致病菌的最小抑菌浓度值,并与临床常用的氟喹诺酮类药物相比较分析,结合人体药代动力学参数,初步确定安妥沙星对常见细菌的临界浓度。结果对临床分离致病菌的MIC测定值显示,安妥沙星的抗菌作用与左氧氟沙星接近,安妥沙星体外抗菌活性与左氧氟沙星相关性最好,安妥沙星一次口服300mg后药代动力学参数与左氧氟沙星一次口服400mg相似,综合PK/PD理论,初步设定安妥沙星琼脂稀释法体外抗菌活性测定的临界浓度为,嗜血菌敏感临界浓度为≤1,其它细菌敏感、中介与耐药临界浓度分别为≤2、4和≥8mg/L。结论通过体外抗菌活性比较,结合药代动力学/药效学理论,初步确定了安妥沙星琼脂稀释法体外抗菌活性测定对常见细菌的临界浓度,供临床应用参考与验证。Objective To detect the sensitivity breakpoints of Antofloxacin for agar-dilution test to staphylococci, enterobacteriaceae, non-fermenter and hemophili in primary. Methods The in vitro antibacterial activity of Antofloxacin and other comparators was detected with standard agar dilution method. Referring to the in vitro antibacterial activity of fluoroquinolones and pharmacokinetics/pharmacodynamics property of the investigated agents, the breakpoints of antoflocaxin were formulated. Results The in vitro antibacterial activity of Antofloxacin against clinical isolates showed the best association with those of levofloxacin. The major pharmacokinetics parameters of Antofloxacin after single oral dose administration of 300mg were comparable with those of levofloxacin after 400mg oral administration. The sensitive breakpoint of Antofloxacin against hemophili was recommended as≤1mg/L; the sensitive, intermediate and resistant breakpoints against other pathogens were≤2, 4 and ≥8mg/L, respectively. Conclusion Referring to the in vitro antibacterial activity and pharmacokinetics/pharmacodynamics parameters, the in vitro sensitive breakpoints of Antofloxacin for agar dilution method were established in primary and recommended for clinical practice and future review.

关 键 词：安妥沙星 临界浓度 最小抑菌浓度 琼脂稀释法 

分 类 号：R978.1[医药卫生—药品]