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目的探讨环丙沙星或阿米卡星分别联合4种临床常用抗铜绿假单胞菌β-内酰胺类抗生素的体外联合抑菌效应。方法2004-01—2004-09北京协和医院检验科用微量肉汤稀释法测定6种测试药物对35株临床分离并具有不同耐药表型的铜绿假单胞菌的MIC值;用肉汤棋盘法测定环丙沙星及阿米卡星分别联合头孢他啶(CAZ)、亚胺培南(IMP)、美罗培南(MEM)、哌拉西林/他唑巴坦(TZP)4种β-内酰胺类药物的联合抑菌效应。结果环丙沙星(CIP)及阿米卡星(AK)分别与4种β-内酰胺类药物联合主要表现出协同和相加作用,AK组出现协同现象的比率(AK+CAZ:71·43%;AK+IMP:42·86%;AK+MEM:54·29%;AK+TZP:85·71%)高于CIP组(CIP+CAZ:20%;CIP+IMP:25·71%;CIP+MEM:14·29%;CIP+TZP:31·43%)。CIP组中CIP+TZP组合协同发生率最高;AK组中AK+TZP组合协同发生率最高。两组均未发现拮抗现象。结论环丙沙星或阿米卡星联合β-内酰胺类抗生素在体外对耐药的铜绿假单胞菌体现出较好的联合抑菌效应。
Objective To investigate the in vitro combined antibacterial effect of ciprofloxacin or amikacin with four kinds of commonly used anti-Pseudomonas aeruginosa β-lactam antibiotics. METHODS: The MIC values of six tested drugs against 35 clinical isolates of Pseudomonas aeruginosa with different drug resistance phenotypes were determined by the micro broth dilution method at the Peking Union Medical College Hospital from January 2004 to September 2004. Method for the determination of ciprofloxacin and amikacin were combined ceftazidime (CAZ), imipenem (IMP), meropenem (MEM), piperacillin / tazobactam (TZP) four kinds of β-lactams Joint antibacterial effect of drugs. Results Ciprofloxacin (CIP) and amikacin (AK) showed synergistic effect with 4 kinds of β-lactam respectively. The ratio of synergism in AK group (AK + CAZ: 71 · (CIP + CAZ: 20%; CIP + IMP: 25.71%; AK + IMP: 42.86%; AK + MEM: 54.29%; AK + TZP: 85.71% ; CIP + MEM: 14.29%; CIP + TZP: 31.43%). CIP group CIP + TZP combination synergistic rate was highest; AK group AK + TZP combination synergistic rate was the highest. No antagonism was found in both groups. Conclusion Ciprofloxacin or amikacin combined with β-lactam antibiotics in vitro drug-resistant Pseudomonas aeruginosa showed a good combination of antibacterial effect.