浅谈诺氟沙星

诺氟沙星(氟哌酸、Norfioxacin、Nflx)是第三代氟化喹酮类抗菌药物。经过几年的临床应用,认为该药具有抗菌谱广、活性强、口服耐受性好,对细菌呈杀菌作用等优点。     

以杀菌曲线方法测定丙氟哌酸对绿脓杆菌、大肠杆菌、金黄色葡萄球菌的抗菌活性、与抗生素的活性比较及协同作用

丙氟哌酸(Ciprofloxacin BAY 09867)——喹啉羧酸的衍生物,有广泛的抗菌范围,特别对肠杆菌科的细菌极其有效;许多对氨基糖苷类及β-内酰胺抗生素类耐药的细菌对该药敏感。本文对丙氟哌酸体外抗菌活性,尤其是有关其初期杀菌活性进行了探讨。丙氟哌酸对绿脓杆菌和大肠杆菌的MIC/MBC分别是0.016/0.03和0.016/     

国产氧氟沙星与其它氟喹诺酮类药物的体外抗菌活性研究

本文报道国产氧氟沙星对临床分离的618株致病菌的体外抗菌活性研究结果,并与环丙沙星、培氟沙星、依诺沙星和诺氟沙星进行比较。结果表明氧氟沙星、培氟沙星和环丙沙星对金葡球菌和表葡球菌均敏感,其抑菌率分别为100％、99％和99.1％;5种喹诺酮类药物对肠杆菌科细菌显示明显的抗菌活性;对绿脓杆菌的抗菌活性以环丙沙星最强,抑菌率为90.90％;5种氟喹诺酮类药物对产β-内酰胺酶的阳性和阴性细菌,其抗菌活性基本一致。     

司氟沙星的体外菌活性研究

采用试管双倍稀释法检测司氟沙星对临床分离的372株致病菌的体外抗菌活性,并与3种同类药物进行比较,结果表明司氟沙星对金葡球菌,表葡球菌和肺炎链球菌等革兰氏阳性菌有较强的抗菌活性,MIC5°－0．03－0．06mg/L,抑菌率75％－93．8％,对革兰氏阴性菌中的伤寒沙门氏菌,痢疾志贺氏菌亦有较强的抗菌作用,MIC90 0．06－1．0mg/L,抑菌率92．5－100％,除粘质沙雷氏菌和柠檬酸丁酐菌耐药率较高外,对多数肠杆菌科细菌亦有53．1％－85．7％的抑菌率。     

丙氟哌酸的实验室和临床研究

丙氟哌酸(Bay 09867,Ciprofloxacin,CIP)是西德 Bayer 药厂研制的吡啶酮酸类抗菌药,抗菌谱甚广,对革兰氏阴性(G~-)细菌和G~+细菌都有抗菌活性,抗菌作用强,优于氟哌酸,也     

丙氟哌酸与其它抗菌剂联合对厌氧菌的抗菌作用

丙氟哌酸(Ciprofloxacin)是活性最强的氟代喹诺酮类药物之一,体外抗菌试验表明,对分枝杆菌、脊髓病毒属、衣原菌属等需氧菌有强的活性,但抗厌氧菌活性呈中等强度(在1μg/ml下,抑制4%细菌生长),并且这种活性随培养基不同(在Wilking-Chalgrem培养基上抗菌活性强于Brucella培养基)和pH改变(pH为7时抗菌活性强于6)而变化,为提高其抗厌氧菌活性,加拿大温哥华总医院研究人员将丙氟哌酸分别与氯林霉素、甲硝唑(Metronidazole)、头孢西丁、美洛西林、头孢噻肟等按一定比例联合。从临床分离了代表六个主要厌氧菌属耐喹诺酮类的598株厌氧菌,用Wilkins-Chalgren培养基的琼脂稀释法试验证明:丙氟哌酸与头     

司氟沙星的体外抗菌活性研究

采用试管双倍稀释法检测司氟沙星对临床分离的３７２株致病菌的体外抗菌活性,并与３种同类药物进行比较。结果表明司氟沙星对金葡球菌、表葡球菌和肺炎链球菌等革兰氏阳性菌有较强的抗菌活性,ＭＩＣ５０≤０．０３～０．０６ｍｇ／Ｌ,抑菌率７５％～９３．８％;对革兰氏阴性菌中的伤寒沙门氏菌、痢疾志贺氏菌亦有较强的抗菌作用,ＭＩＣ９００．０６～１．０ｍｇ／Ｌ,抑菌率９２．５％～１００％;除粘质沙雷氏菌和柠檬酸杆菌耐药率较高外,对多数肠杆菌科细菌亦有５３．１％～８５．７％的抑菌率。     

氟啶酸——溴化脱溴化氢温度考察

氟啶酸是含氟吡酮酸类抗菌药，抗菌谱广，对革兰氏阴性，阳性细菌均有很强的抗菌作用。本品体外抗菌作用和氟哌酸相似，但由于口服吸收迅速，血尿浓度均比较高，分布良好，体内抗菌活性明显优于氟哌酸，对金黄色葡萄球菌，大肠杆菌，肺炎杆菌，     

头孢他啶/阿维巴坦对耐碳青霉烯肠杆菌科细菌的体外抗菌活性研究

目的 头孢他啶/阿维巴坦(CAZ/AVI)是第三代头孢菌素和新型的非β-内酰胺酶类的β-内酰胺酶抑制剂阿维巴坦相 结合的抗生素,对多重耐药菌具有抗菌活性,本研究评价CAZ/AVI对临床分离耐碳青霉烯肠杆菌科细菌(carbapenem-resistant Enterobacteriaceae,CRE)的体外抗菌活性,同时评价CAZ/AVI对不同菌属的CRE菌和携带不同耐药基因型的CRE菌的体外抗菌 活性。方法 对收集来自解放军302医院和宁夏医科大学总医院2008年1月至2017年12月临床分离的266株CRE菌株进行了最低抑 菌浓度(minimum bacteriostatic concentration, MIC)的测定;采用特异引物扩增法进行耐药基因型的测定,进一步分析CAZ/AVI对 携带不同耐药基因型的CRE菌的体外抗菌活性。结果 CAZ/AVI体对临床分离CRE菌的体外抑菌活性为49.62%,明显优于头孢 他啶和其他对照药物(P=0),但弱于多黏菌素B和替加环素(P=0.003);对克雷伯菌属CRE菌的体外抑菌效果明显,可达到63.75% 的体外活性抑菌率,其次为肠杆菌属CRE菌(23.81%),对埃希菌属CRE菌的体外抑菌率最低(13.33%);对于携带blaKPC-2 基因型 的CRE菌株体外抑菌率可达到69.23%,而对于携带blaNDM 和blaIMP 的基因型的CRE菌株作用相当(P=0.889),体外抑菌率分别为 2.22%和8.33%。结论 CAZ/AVI坦对CRE菌表现出了一定的体外抗菌活性优势,尤其是增强了头孢他啶的体外抗菌活性。对克 雷伯菌属CRE菌的体外抑菌活性明显,并且能够很好的抑制携带blaKPC-2 基因型的CRE菌。     

氟喹诺酮类抗菌剂的进展

自1977年氟哌酸(Nor floxacin)研制成功以来,结束了10余年4-喹诺酮类(4-quinolones)各种抗菌剂仅对部分革兰氏阴性细菌有抗菌活性的局面。氟哌酸对革兰氏阴性菌比老产品有更广更强的抗菌活性,对革兰氏阳性菌,绿脓杆菌和条件致病菌同样有很强抗菌作用,而且其与抗生素或其他抗菌药无交叉耐药。其化学结构与老产品区别在于     

五倍子水煎剂对124株表皮葡萄球菌(MRSE和MSSE)的体外抗菌活性观察

目的 观察五倍子水煎剂对124株表皮葡萄球菌(methicillin-resistant staphylococcus epidermidis,MRSE和methicillin-sensitivity staphylococcus epidemaidis,MSsE)的体外抗菌活性。方法 采用新的中药抑菌实验方法对五倍子水煎剂进行了体外抗菌活性检测。结果 五倍子对耐甲氧西林的表皮葡萄球菌(MRSE)和甲氧西林敏感表皮葡萄球菌(MSSE)的抗菌活性均较好,其MIC90均为0．203mg/ml(1：1280),其MIC50均为0．051mg/ml(1：10240)。结论 此项研究为临床治疗由表皮葡萄球菌引起的感染,提供了科学依据。     

国产替考拉宁对耐甲氧西林表皮葡萄球菌的体外抗菌活性观察

评价国产替考拉宁对耐甲氧西林表皮葡萄球菌（MRSE）和甲氧西林敏感表皮葡萄球菌（MSSE）的体外抗菌活性，用琼脂二倍稀释法测定了84株MRSE和28株MSSE临床菌株的最低抑菌浓度，并与万古霉素进行了比较，结果表明国产替考拉宁对48株MRSE和28株MSSE抑菌效果较好，其敏感率分别为97．62％和100％。     

Clinical evaluation of tinidazole on anaerobic infections in the field of obstetrics and gynecology

The bacteriological and clinical effect of tinidazole (TDZ) was evaluated in 16 cases of intrauterine, intrapelvic and vulvar infection caused by anaerobic organisms and the following results were obtained. Anaerobes were detected in 16 cases, including 1 case with anaerobes alone and 15 cases with mixed anaerobes and aerobes. Eight different species and 24 strains were detected. A single species was isolated from 9 cases, 2 species from 6 cases and 3 species from 1 case. The main species detected were Bacteroides fragilis and Peptostreptococcus spp. of which 9 strains (37.5%) each were isolated. Escherichia coli and B. fragilis was the most frequently occurring combination. The peak MIC values of TDZ were 0.78 micrograms/ml for B. fragilis and 1.56 micrograms/ml for Peptostreptococcus spp. Most other organisms were also sensitive to TDZ. The bacteriological response of the anaerobic infections to TDZ was 87.5% and overall clinical efficacy was 87.5%. Few side effects were observed.     

Study on the safety and efficacy of sitafloxacin--results of the use-results survey

Sitafloxacin (STFX, Gracevit 50 mg, fine granules 10%), a new quinolone antibacterial agent, was approved in January 2008, and the use-results survey was performed for 2 years from December 2008 to November 2010. In total, 3558 case cards were collected from 287 medical institutions and 3331 cases were subjected to a safety evaluation and 3225 were subjected to an efficacy evaluation. Incidence of adverse drug reactions (ADRs) was 4.44% (148/3331 cases). Major ADRs were diarrhea (55 cases) and hepatic function disorders (39 cases), and the incidences were 1.65% and 1.17%, respectively. Serious ADRs were observed in 5 cases (7 episodes); gastrointestinal haemorrhage, hepatic function abnormal, white blood cell count decreased, drug eruption, hypoglycemia, pneumonia, and superinfection in one case each. Efficacy rate was 92.9% (2997/3225 patients) in total with a range of 91.4 to 97.8% by type of infection such as respiratory tract and urinary tract. Eradication rate of indicated strains was 91.5% (808/883 strains) including Gram-positive bacteria at 92.3% (310/336 strains), Gram-negative bacteria at 90.7% (458/505 strains), anaerobes at 100.0% (28/28 strains) and atypical bacteria at 85.7% (12/14 strains). In conclusion, this use-results survey confirmed that STFX is a useful antibacterial agent with no serious problems in its safety profile and efficacy rates of over 90% against all infections.     

亚胺培南治疗重症下呼吸道感染的临床分析

目的:了解亚胺培南治疗重症下呼吸道感染的疗效和安全性.方法:回顾性分析亚胺培南治疗16例重症下呼吸道感染病例的疗效和不良反应.结果:14例治疗有效,有效率87.5%;共检出细菌9株,用药后清除7株(77.8%),2株未清除［1株为耐甲氧西林的金黄色葡萄球菌(MRSA),1株为绿脓杆菌］.16例中,1例有轻度恶心、头昏不适.结论:亚胺培南对重症下呼吸道感染有良好疗效,使用安全,可作为治疗致病菌不明的严重下呼吸道感染或混合菌感染的较为理想的经验性治疗药物.     

甲磺酸左氧氟沙星对耐青霉素肺炎链球菌的体外抗菌活性

目的 观察甲磺酸左氧氮沙星对耐青霉素肺炎链球菌(PRSP)的药敏及疗效。方法 对6株临床分离的耐青霉素肺炎链球菌，采用E—test方法，测定甲磺酸左氧氮沙星等6种抗生素的抗菌活性。同时观察甲磺酸左氧氮沙星单药治疗取SP临床疗效及不良反应。结果6株取SP均为低耐药菌株，对甲磺酸左氧氮沙星敏感。6例患者经治疗后，5例痊愈，l例显效，无明显副反应发生。结论 甲磺酸左氧氮沙星可有效治疗耐青霉素肺炎链球菌性肺炎。     

慢性化脓性骨髓炎212例细菌培养及耐药性分析

目的:分析慢性化脓性骨髓炎致病菌及其耐药情况,为临床抗菌用药提供依据。方法:对从临床送检的281份标本中选出符合要求的212份标本行细菌培养和耐药性分析。结果:212份标本经细菌培养,共分离出致病菌252株,其中G 球菌142株,G-杆菌101株进行耐药性分析,另9株分枝杆菌未做耐药性分析。耐药菌株多集中在苯唑西林耐药的葡萄球菌,在G-杆菌中;单种药物以青霉素G平均耐药率最高达90.8%,呋喃妥因平均耐药率为0.7%。结论:慢性化脓性骨髓炎的致病菌多数对医院常用的抗菌药产生耐药,而对一些目前已很少应用的老抗菌药反而敏感,这种现象需引起临床医师的重视。     

千根草粗取物体外抑菌活性部位的筛选研究

目的 以金黄色葡萄球菌、大肠杆菌、变异链球菌、绿脓杆菌、伤寒杆菌、痢疾杆菌为试验菌株研究千根草的体外抑菌活性.方法 通过K-B纸片扩散法及利用连续（试管）稀释法对70%醇提物,水层、正丁醇、乙酸乙酯、石油醚相萃取物测定抑菌活性.结果 总提物对金黄色葡萄球菌、绿脓杆菌、伤寒杆菌、痢疾杆菌的最低抑菌浓度（MIC）为25.00g·L-1.粗分部位中,乙酸乙酯相萃取物对金黄色葡萄球菌、大肠杆菌、绿脓杆菌、痢疾杆菌抑菌活性最好,其最低抑菌浓度分别为25、12.5、3.13、25g·L-1,水层无抑菌活性.结论 千根草的抑菌活性成分主要存在于乙酸乙酯萃取相中.     

A study on in vitro antibacterial activity and clinical usefulness in respiratory tract infections of panipenem/betamipron, a newly synthesized carbapenem antibiotic]

Panipenem/betamipron (PAPM/BP) is a combination drug of PAPM, a new parenteral carbapenem antibiotic and BP, an amino acid derivative at a weight ratio of 1:1. Its in vitro antibacterial activities against clinically isolated respiratory pathogenic bacteria were determined. It was superior to imipenem (IPM) in the in vitro antibacterial activities against Haemophilus influenzae, Haemophilus parainfluenzae, Branhamella catarrhalis, Staphylococcus aureus including MRSA, Klebsiella pneumoniae, Serratia marcescens and Escherichia coli. PAPM had antibacterial activities almost equal to those of IPM against Streptococcus pneumoniae and Enterococcus spp. Against Pseudomonas aeruginosa, however, its antibacterial activity was about 1/4 that of IPM. The clinical usefulness of PAPM/BP was studied by dissolving it in a solution containing lactate and administering the solution by intravenous drip infusion to 12 cases of respiratory tract infections. Out of 11 cases with respiratory tract infections excluding cytomegalovirus pneumonia, the efficacy rate was 90.9%, with 4 cases of excellent and 6 cases of good responses. In terms of its bacteriological efficacies, eradication of pathogenic bacteria including super-infection were observed in 2 out of 4 strains, but 2 strains of P. aeruginosa remained unchanged. Six strains appeared as superinfected bacteria during and after administration of this preparation substituting original pathogens. Side-effects were not observed in the 12 cases, and in laboratory tests, slight transient increases of S-GOT and S-GPT were found in 1 case. In conclusion, PAPM/BP is a very useful parenteral antibiotic against respiratory tract infections and can be one of the drugs of the first choice.     

Fundamental and clinical studies of ceftazidime in the field of pediatrics

We have studied ceftazidime (CAZ), a cephem antibiotic of the new generation, for its antibacterial activity against H. influenzae and clinical effects. Antibacterial activity: MICs of CAZ for 142 strains of H. influenzae including 11 ABPC-resistant strains which were clinically isolated, were determined, and the results were good for all the strains. Clinical effects: CAZ was administered to 9 children with infections. Suspected causative organisms were H. influenzae, E. coli, P. aeruginosa, group B Streptococcus and S. pneumoniae. Eradication of these organisms was confirmed in all the strains except for one in which the antibacterial effect of CAZ was unknown. Clinical efficacy was excellent or good in all the cases. No side effect was observed except for eosinophilia noted in 1 case.