甲氧苄氨嘧啶与头孢氨苄体外联合抗菌作用  

In Vitro Synergistic Acting of Trimethopnim and Cefalexin

作　　者：刘健[1] 钟巍[1] 康子胜[1] 杨维维[1] 肖永红[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》2003年第1期17-22,共6页The Chinese Journal of Clinical Pharmacology

摘　　要：目的:评价头孢氨苄-甲氧苄氨嘧啶(TMP)(5:1)的复方制剂对临床分离的636株致病菌体外抗菌作用结果以及头孢氨苄与TMP对临床分离的99株致病菌联合敏感实验研究结果。方法:最低抑菌浓度(MIC)测定采用平皿二倍稀释法,联合敏感实验采用平皿二倍稀释棋盘法。结果:头孢氨苄-TMP(5:1)的复方制剂对革兰阴性菌中的沙雷菌、弗劳地枸橼酸菌、普通变形杆菌、奇异变形杆菌、摩氏摩根菌、嗜血流感杆菌都有不同程度的增效作用,抗菌活性提高了2～32倍。复方制剂特别提高了对那分耐药肠杆菌的抗菌作用,如产气肠杆菌、阴沟肠杆菌的MIC值明显降低,尤其是产气肠杆菌MIC_(50)值从256mg·L^(-1)降为8mg·L^(-1),增效作用增加了32倍。复方制剂明显提高了对甲氧西林耐药的金葡菌的抗菌活性,均由原来的MIC_(50)、MIC_(90)≥256mg·L^(-1)分别降至2,16mg·L^(-1)。头孢氨苄与TMP联合敏感实验结果表明,对革兰阴性菌中的产气肠杆菌、阴沟肠杆菌、弗劳地枸橼酸菌协同率分别为92.3%,84.6％和62.5％,具有较好的协同作用。对革兰阳性菌中的金葡和表葡,协同率也分别达到64.3%,56.3％。无拮抗现象。结论:TMP对头孢氨苄具有一定的增效作用。头孢氨苄-TMP(5:1)的复方制剂扩大了抗菌谱,提高了抗菌活性。OBJEKTIVE: To evaluate the in vitro activity of cefalexin-trimethopnim (TMP) (5:1) against 636 clinical isolates and synergistic acting of cefalexin and TMP against 99 clinical isolates. METHODS: MICs were determined by the twofold agar dilution method. RESULTS: Cefalexin-TMP (5:1) could enhance the antibacterial activities 2 to 32 times against Serratia spp., Citrobacter freunddi, Proteus vulgaris, Protues mirabilis, Morganella morganii and Haemophilus influenzas. The combination could improve the antibacterial activities against some resistant-Enterobacters, such as Enterobacter aerogenes, Enterobacter cloacae, et al. The value of MIC50 of Enterobacter aerogenes was decreased from 256mg.L-1 to 8mg.L-1. The combination could improve the antibacterial activities against MRSA also and decrease the values of MIC50and MIC90from 256mg.L-1 to 2, 16mg.L-1, respectively. The results of combined susceptible test show that synergistic rates of Enterobacter aerogenes, Enterobacter cloacae, Citrobacter freunddi, Staphylococcus aureus and Staphylococcus epidermidis were 92.3%, 84.6% ,62.5%, 64.3% and 56.3%, respectively. CONCLUSION: TMP and cefalexin exhibited synergistic action and the combination could expand antibacterial spectrum and enhance the antibacterial activity.

关 键 词：头孢氨苄 甲痒苄氨嘧啶 体外 抗菌作用 

分 类 号：R978.11[医药卫生—药品]