万古霉素和利福平联用对耐甲氧西林金黄色葡萄球菌的体外抗菌活性评价  

Evaluation on in vitro antibacterial activity of vancomycin combined with rifampin against MRSA

作　　者：张寅英[1] 李晔[1] 

机构地区：[1]嘉兴市妇幼保健院临床药学室,浙江314000

出　　处：《现代医药卫生》2016年第22期3423-3425,共3页Journal of Modern Medicine & Health

基　　金：浙江省嘉兴市科技局一般科技计划项目(2014AY21047)

摘　　要：目的评价万古霉素与利福平对耐甲氧西林金黄色葡萄球菌(MRSA)的联合体外抗菌活性。方法采用微量肉汤稀释法分别测定万古霉素和利福平对30株MRSA的最低抑菌浓度(MIC),考察两药单用对MRSA的抗菌活性;以测得的单药MIC为依据,采用棋盘法设计,测定并计算万古霉素和利福平联用对30株MRSA的部分抑菌浓度指数,考察两药联用对MRSA的抗菌活性。结果 30株MRSA对万古霉素和利福平的耐药率分别为3.3%、90.0%。两药联用后绝大部分表现为协同作用[86.7%(26/30)],少部分为相加作用[13.3%(4/30)],未见表现为无关及拮抗作用者。结论万古霉素和利福平单药对MRSA均表现为部分有效,两药联用后对MRSA的抗菌活性增强,以协同作用为主,临床治疗MRSA引起的严重感染可考虑根据药敏试验结果采用万古霉素和利福平联合用药方案。Objective To evaluate the in vitro antibacterial activity of combination of vancomycin and rifampin against methicillin-resistant staphylococcus aureus （MRSA）. Methods The minimal inhibitory concentration （MIC） of vancomycin and rifampin on 30 strains of MRSA was respectively detected by using the broth dilution method;with the detected single drug MIC as the basis,the fraction inhibitory concentration（FIC） of the combination of vancomycin plus rifampin against 30 strains of MRSA was detected by adopting the checkerboard design. The antibacterial activity of combination of these two drugs on MRSA was in-vestigated. Results The resistant rate of 30 strains of MRSA to vancomycin and rifampin was 3.3%and 90%respectively. Most manifestations of 2-drug combined medication were the synergic action[86.7%（26/30）] and the minority were the additive action [13.3%（4/30）],neither non-correlative nor antagonism action was seen. Conclusion Single vancomycin and rifampin to MRSA manifest the partial effect,after their combination,the antibacterial activity to MRSA is enhanced,which is mainly synergic action. Clinically treating severe infection caused by MRSA can adopt the combination scheme of vancomycin and rifampin according to the drug susceptibility test results.

关 键 词：甲氧西林抗药性 葡萄球菌 金黄色 万古霉素/药理学 利福平/药理学 

分 类 号：R378.11[医药卫生—病原生物学]