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目的 探讨羟氨苄青霉素 +克拉维酸 (安奇 )的体外抗菌活性并对其治疗急性呼吸道感染的疗效与成本进行评价。方法 体外测定羟氨苄青霉素 +克拉维酸对常见致病菌的最低抑菌浓度(MIC)、最小杀菌浓度 (MBC)和杀菌曲线 ,并和同类不含 β 内酰胺酶抑制剂抗生素进行比较。将 80例临床诊断为呼吸道感染的患儿 ,随机分为安奇静脉注射、安奇静脉 口服序贯疗法、凯兰欣静脉注射、西力欣静脉注射 4组 ,观察临床疗效并进行成本 效果分析。结果 安奇对 14 0株实验菌的MIC和MBC值及杀菌曲线结果优于同类不含 β 内酰胺酶抑制剂抗生素 ,安奇对多种致病菌的抗菌效果优于益萨林、先锋 5、西力欣、头孢曲松 ,特别是对产超广谱 β 内酰胺酶 (ESBLs)肺炎克雷伯菌和大肠埃希菌效果更为明显。序贯疗法成本 效果比明显小与其它治疗组。结论 安奇作为羟氨苄青霉素与 β 内酰胺酶抑制剂克拉维酸的联合制剂 ,比现有同类不含 β 内酰胺酶抑制剂抗生素具有更广的抗菌谱和更强的抗菌作用 ,对产ESBLs肺炎克雷伯菌和大肠埃希菌效果有其优势 ,提示临床在呼吸道感染 ,特别是产ESBLs革兰阴性杆菌感染时可选用。安奇静脉 口服序贯疗法临床疗效确切 ,安全、经济方便 ,值得临床推广。
Objective To investigate the in vitro antibacterial activity of amoxicillin plus clavulanic acid and to evaluate its efficacy and cost in the treatment of acute respiratory infections. Methods The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and bactericidal curve of amoxicillin + clavulanic acid against common pathogenic bacteria were determined in vitro and compared with those of antibiotic without β lactamase inhibitor. Eighty children with clinically diagnosed respiratory tract infection were randomly divided into four groups: An Qi injection, Anqi oral sequential therapy, Kailaxin injection and Xili injection. The clinical efficacy and cost-effectiveness analysis . Results The results of MIC and MBC values and bactericidal curves of 140 experimental strains were better than those of other antibiotics without β-lactamase inhibitor. The antibacterial effect of Anqi on various pathogenic bacteria was better than that of Yisalin, Pioneer 5 , Celecoxib, ceftriaxone, especially for the production of ESBLs Klebsiella pneumoniae and Escherichia coli effect is more obvious. Sequential therapy cost-effective ratio was significantly smaller with other treatment groups. Conclusions Anqi, as a combination formulation of amoxicillin and β-lactamase inhibitor clavulanic acid, has a broader antibacterial spectrum and antibacterial activity than existing antibiotics without β-lactamase inhibitor, Klebsiella pneumoniae and Escherichia coli have their advantages, suggesting that the clinical use of respiratory infections, especially ESBLs Gram-negative bacilli infection may be used. Anqi vein oral sequential therapy clinical curative effect is safe, economical and convenient, it is worth clinical promotion.