CAJ | 학술논문

目的探讨头孢曲松/他唑巴坦复方(CRO/TAZ)对产β-内酰胺酶大肠埃希菌的体外抗菌活性(MIC)、抗生素后效应(PAE)、β-内酰胺酶抑制剂后效应(PLIE)和抗生素亚抑菌浓度后效应(PASME).方法采用琼脂二倍稀释法测定CRO/TAZ和CRO对产4种酶型β-内酰胺酶E.coli菌株的MIC;以微量接种菌落计数法测定菌落形成单位(CFU),绘制细菌生长曲线,并计算PAE、PLIE和PASME.结果 CRO/TAZ复方对产β-内酰胺酶菌株的MIC较CRO单方降低都在8倍以上;无论CRO单方还是CRO/TAZ复方均无长的PAE(-0.59～0.85 h);PLIE和PASME随着菌株β-内酰胺酶酶型的不同而不同,相同酶型的菌株PLIE和PASME很接近;PLIE(0.62～3.22 h)和大多数PASME(0.12～5.61 h)都较其PAE长,而且对CRO单方MIC较小的菌株,其PAE、PLIE和PASME较长.结论 PLIE和PASME的长短可能与β-内酰胺酶酶型有关.对于有较长PLIE和PASME的菌株,在制定临床给药方案时可适当延长给药间隔;PAE、PLIE和PASME理论为研究抗菌药物药效学和设计合理给药方案、优化给药模式提供重要参考和新思路.
목적 탐토두포곡송/타서파탄복방(CRO/TAZ)대산β-내선알매대장애희균적체외항균활성(MIC)、항생소후효응(PAE)、β-내선알매억제제후효응(PLIE)화항생소아억균농도후효응(PASME).방법 채용경지이배희석법측정CRO/TAZ화CRO대산4충매형β-내선알매E.coli균주적MIC;이미량접충균락계수법측정균락형성단위(CFU),회제세균생장곡선,병계산PAE、PLIE화PASME.결과 CRO/TAZ복방대산β-내선알매균주적MIC교CRO단방강저도재8배이상;무론CRO단방환시CRO/TAZ복방균무장적PAE(-0.59～0.85 h);PLIE화PASME수착균주β-내선알매매형적불동이불동,상동매형적균주PLIE화PASME흔접근;PLIE(0.62～3.22 h)화대다수PASME(0.12～5.61 h)도교기PAE장,이차대CRO단방MIC교소적균주,기PAE、PLIE화PASME교장.결론 PLIE화PASME적장단가능여β-내선알매매형유관.대우유교장PLIE화PASME적균주,재제정림상급약방안시가괄당연장급약간격;PAE、PLIE화PASME이론위연구항균약물약효학화설계합리급약방안、우화급약모식제공중요삼고화신사로.
Objective To study post antibiotic effect (PAE), post β-lactamase inhibitor effect (PLIE) and post antibiotic sub-MIC effect (PASME) of ceftriaxone/tazobactam on β-lactamase-producing Escherichia coli in vitro. Methods The minimal inhibitory concentration (MIC) of ceftriaxone/tazobactam against 4 types of β lactamase producing E. colis strains, was measured by two-fold agar dilution method. The numbers of CFU on plates were counted by micro-inoculation colony counting method. The growth kinetics curves of the bacteria were drawn according to CFU counts, from which the PAE. PLIE and PASME were calculated. Results The MIC of the ceftriaxone/tazobactam combination was eight times more than ceftriaxone alone. No longer PAE (-0. 59-0. 85 h) was found in the ceftriaxone/tazobactam combination or any of them alone. The PLIE and PASME varied according to the type of β-lactamase but similar results were observed for the strains producing the same type β-lactamase. All PLIEs (0. 62-3. 22 h) and most PASMEs (0.12-5. 61 h) were longer than PAEs. The lower MIC of ceftriaxone the strain had, the longer the PAE, PLIE and PAMSE were. Conclusion The duration of PLIE and PASME may concerned with the type of β-lactamase. With both longer PLIE and PASME, longer dosing interval should be recommended. The PAE, PLIE and PASME provide an important instrument for pharmacodynamic studies of antibiotics, in particular for the design of dosing schedules.