头孢吡肟的体外抗菌作用研究  

In vitro antibacterial activity of cefepime

作　　者：张婴元[1] 张敬德[1] 周乐[1] 吴培澄[1] 王宇倩[1] 汪复[1] 

机构地区：[1]上海医科大学华山医院抗生素研究所,上海200040

出　　处：《中国抗生素杂志》1999年第5期359-364,共6页Chinese Journal of Antibiotics

摘　　要：对第四代头孢菌素头孢吡肟的体外抗菌作用进行评价并与其他８种抗菌药进行比较。以琼脂双倍稀释法测定头孢吡肟等对７５９ 株临床分离菌的最低抑菌浓度（ＭＩＣ），也测定了该药的最低杀菌浓度（ＭＢＣ）及杀菌曲线。研究结果显示头孢吡肟对肠杆菌科细菌、流感杆菌、甲氧西林敏感葡萄球菌、链球菌属、消化链球菌和丙酸杆菌属具有高度抗菌活性，ＭＩＣ９０在≤０．０６～４ｍ ｇ／Ｌ。该药对铜绿假单胞菌、鲁氏不动杆菌亦具良好抗菌作用，ＭＩＣ９０≤４～８ｍ ｇ／Ｌ。甲氧西林耐药葡萄球菌、肠球菌属、脆弱拟杆菌的大多菌株对头孢吡肟呈现耐药。与其他受试药相比，头孢吡肟对肠杆菌科细菌，尤其是阴沟肠杆菌、产气肠杆菌、聚团肠杆菌、柠檬酸杆菌属、肺炎克雷伯氏菌的抗菌活性明显高于受试的β－内酰胺类抗生素和阿米卡星，但略低于亚胺培南，与环丙沙星大致相仿，其中头孢吡肟对大肠埃希氏菌的抗菌活性远高于环丙沙星。头孢吡肟对假单胞菌属、不动杆菌属和革兰氏阳性球菌的抗菌作用与受试的各有关药物大致相仿。头孢吡肟为一杀菌剂，对肠杆菌科细菌杀菌作用强，其ＭＩＣ值与ＭＢＣ值相仿，对铜绿假单胞菌及金葡菌的杀菌作用弱于对肠杆菌科细菌者。The in vitro antibacterial activity of cefepime, the fourth generation cephalosporin, was evaluated and compared with those of 8 antibacterial agents. Altogether 759 clinical isolates were tested. Of which gram negative bacilli 562, gram positive cocci 137 and anaerobes 60. The MICs were determined using a two fold agar dilution method. MBCs and bactericidal curves were performed. Results showed that cefepime was highly active against Enterobacteriaceae, H.influenzae , methicillin sensitive Staphylococcus, Streptococcus spp., Peptostreptococcus spp. and Propionibacterium spp. with MIC 90 of ≤0.06~4mg/L. It was also active against, P.aeruginosa, A.lwoffi with MIC 90 of 4~8mg/L. Most strains of MRSA, MRSE, Enterococcus spp. and B.fragilis were resistant to cefepime. Compare with the other tested agents, cefepime was more active against Enterobacteriaceae, especially E.cloacae, E.aerogenes, E.agglomerans , Citrobacter spp. K.pneumoniae , than that of the other β lactams and amikacin, but slightly less active than that of imipenem, as active as ciprofloxacin (except E.coli ). The activity of cefepime against Pseudomonas spp., Acinetobacter spp. and gram postive cocci was similar to related tested agents. Cefepime is a bactericidal agent. It had strong bactericidal activity against strains of Enterobacteriaceae at concentrations near the MICs, but was weaker against P.aeruginosa and S.aureus .

关 键 词：头孢吡肟 体外抗菌 活性 

分 类 号：R978.11[医药卫生—药品]