舒巴坦与第三代头孢菌素联合对第三代头孢菌素耐药菌的体外抗菌作用研究  

The in vitro Activity of Sulbactam in Combination with Third Generation Cephalosporins Against Third Generation Cephalosporins Resistant Bacteria

作　　者：张永龙[1] 李家泰[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：《中国临床药理学杂志》2000年第5期323-326,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的：探讨舒巴坦与头孢他啶、头孢噻肟、头孢呋辛1:1联合对头孢他啶或头孢呋辛耐药的革兰阴性杆菌及金葡球菌的体外抗菌增效作用。方法：用平皿二倍稀释法测定了舒巴坦与头孢他啶、头孢噻肟、头孢呋辛1:1联合的体外抗菌作用。结果：舒巴坦可以增强头孢他啶、头孢噻肟及头孢呋辛对革兰阴性杆菌的体外抗菌活性。舒巴坦可以使头孢他啶对大肠杆菌、阴沟肠杆菌、弗劳地枸橼酸杆菌、不动杆菌属、铜绿假单胞菌的MIC90降低4倍；使头孢噻肟对大肠杆菌、阴沟肠杆菌、弗劳地枸橼酸杆菌、不动杆菌属的MIC90降低2～4倍，但对金葡球菌、肠球菌及嗜麦芽窄食单胞菌无明显的增效作用。38.4%的对头孢他啶耐药的大肠杆菌、45.3%的对头孢他啶耐药的阴沟肠杆菌、66.6%的对头孢他啶耐药的弗劳地枸橼酸杆菌及60％的对头孢他啶耐药的不动杆菌属对舒巴坦与头孢他啶（1:1）的联合制剂敏感。结论：舒巴坦与头孢他啶联合对头孢他啶耐药菌有30%～40％的抗菌增效作用。OBJECTIVE: To study the in vitro activities of the ?-lactamase inhibitor sulbactam combined with ceftazidime, cefotaxime, cefuroxime at the ratio of 1:1 against ceftazidime or cefuroxime resistant gram-negative rods and S.aureus. METHODS: The in vitro combination antibacterial activities were studied by using two-fold plate dilution methods. RESULTS: The results showed sulbactam could enhance the antibacterial activities of ceftazidime, cefotaxime, cefuroxime against gram-negative rods. It could decreased the MIC90 of ceftazidime against E.coli, E.cloacae, C.freundii, Acinetobacter spp., P.aeruginosa 4 folds and reduced the MIC90 of cefotaxime against E.coli, E.cloacae, C.freundii, Acinetobacter spp. 2~4 folds. However, sulbactam couldn誸 enhance the activities of ceftazidime, cefotaxime, cefuroxime against S.aureus, Enterococcus and Stenotrophomonas maltophilia. 38.4% of ceftazidime resistant E.coli, 45.3% of ceftazidime resistant E.cloacae, 66.6% of ceftazidime resistant C.freundii and 60% of ceftazidime resistant Acinetobacter spp were susceptible to the combination of sulbactam and ceftazidime at the ratio of 1:1. CONCLUSION: Sulbactam could enhance the activity of ceftazidime against 30%~40% ceftazidime resistant bacteria.

关 键 词：第三代头孢菌素耐药菌 头孢他啶 头孢噻肟 头孢呋辛 舒巴坦 体外联合抗菌作用 联合药敏试验 

分 类 号：R969.2[医药卫生—药理学] R978.[医药卫生—药学]