左氧沙星与磷霉素联用对金黄色葡萄球菌的体外杀菌活性研究  

In vitro activities of levofloxacin in combination with fosfomycin against staphylococcus aureus

作　　者：宋秀杰[1] 鞠红梅[2] 于旭红[3] 林德峰[3] 王睿[3] 刘又宁[1] 

机构地区：[1]解放军总医院呼吸科,北京100853 [2]吉林油田总医院 [3]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》2010年第12期1388-1394,共7页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:评价左氧沙星与磷霉素联用对金黄色葡萄球菌的联合抗菌效应。了解左氧沙星单用及与磷霉素联用的杀菌曲线特点。方法:选取3株MSSAATCC29213、临床分离菌SA99、SARN450(实验室菌株)和1株临床分离的MRS-AB6177,采用菌落计数法对不同浓度的左氧沙星或磷霉素单用及两药联合对3株MSSA和1株MRSA进行体外杀菌实验。结果:左氧沙星的杀菌曲线表现出浓度依赖性,磷霉素的杀菌曲线表现出非浓度依赖性。两药1/4MIC浓度单用时虽然均无法抑制MSSA的生长,而两药亚抑菌浓度联合使用后即表现出协同效应和杀菌效应。两药4MIC、8MIC联合时对MRSA表现出杀菌效应。结论:亚抑菌浓度的左氧沙星与磷霉素联合对MSSA即可出现协同杀菌效应。左氧沙星联合磷霉素对MRSA也表现出显著的杀菌活性。AIM：To investigate the in vitro bactericidal activity of levofloxacin alone and combined with fosfomycin against 3 strains MSSA and 1 stain MRSA. METHODS：Three MSSA strains and 1 MRSA from clinical specimens were used in this study.Time-kill curve method was carried out with different concentration of the two drugs both alone and in combination.RESULTS：Levoloxacin alone showed a concentration-dependent time-kill curve against three strains of MSSA,fosfomycin showed a nonconcentration-dependent time-kill curve.Neither levofloxacin nor fosfomycin alone inhibited bacterial growth at 1/4 MIC;but the combination of this two drugs at 1/4 the respective MIC showed a synergistic bactericidal effect,a 2-3 log10 decrease with respect to the most active antibiotic alone.CONCLUSION：The combination of subinhibitory concentrations of levofloxacin and fosfomycin presented synergism,exerting a bactericidal effect.The combination also has a bactericidal effect against MRSA.

关 键 词：金黄色葡萄球菌 左氧沙星 磷霉素 杀菌曲线 

分 类 号：R965.2[医药卫生—药理学]