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目的:比较不同配比的头孢曲松钠/舒巴坦钠(CRO/SBT)及头孢曲松钠(CRO)单剂对黑龙江地区临床分离致病菌的体外抗菌活性。方法:采用琼脂二倍稀释法测定不同配比CRO/SBT复方制剂(1∶1,2∶1,4∶1,8∶1)对鲍曼不动杆菌、表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌等6种临床分离致病菌株(共183株)的最低抑菌浓度(MIC),采用肉汤二倍稀释法测定最小杀菌浓度(MBC),并与单方CRO进行比较。结果:对于鲍曼不动杆菌和产ESBLs大肠埃希菌、肺炎克雷伯菌,4种CRO/SBT不同配比的复方可使耐药率从单用CRO的46.7%～100%下降至4.17%～67%,下降幅度达6～10倍,CRO/SBT(1∶1)的MIC50为4～32 mg.L-1,是CRO单方的1/16～1/24;对于不产酶的大肠埃希菌和肺炎克雷伯菌以及耐甲氧西林金黄色葡萄球菌,复方制剂的活性类似于单方。结论:4种配比CRO/SBT对大多数临床分离的致病菌均有较强的体外抗菌活性,明显高于单剂;在复方制剂中,当头孢曲松钠的量一定时,增加舒巴坦钠的量对抗菌活性有一定的增强作用,CRO/SBT(1∶1)为强效广谱杀菌复方制剂。
Objective: To compare the in vitro antibacterial activity of different ratios of ceftriaxone sodium / sulbactam sodium (CRO / SBT) and ceftriaxone sodium (CRO) single agents to clinically isolated pathogens in Heilongjiang Province. Methods: Agar double dilution method was used to determine the effects of different ratios of CRO / SBT compound preparation (1: 1, 2: 1, 4:1 and 8:1) on Acinetobacter baumannii, Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and other six kinds of clinically isolated pathogenic strains (a total of 183 strains) minimum inhibitory concentration (MIC), the use of broth double dilution method for the determination of the minimum bactericidal concentration MBC) and compared with unilateral CROs. Results: In different combinations of Acinetobacter baumannii and ESBLs-producing Escherichia coli and Klebsiella pneumoniae, the four CRO / SBT combinations decreased the drug resistance rate from 46.7% -100% of CRO alone to 4.17 % ~ 67%, a decrease of 6 to 10 times, CRO / SBT (1: 1) MIC50 of 4 ~ 32 mg.L-1, CRO unilateral 1/16 ~ 1/24; Escherichia coli and Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus, the activity of the compound is similar to unilateral. CONCLUSION: The four formulations of CRO / SBT have strong in vitro antibacterial activity against most clinically isolated pathogens, which is significantly higher than that of single dose. In the compound preparation, when the amount of ceftriaxone sodium is constant, The amount of barbata has a certain enhancement effect on antibacterial activity, CRO / SBT (1: 1) is a potent broad-spectrum bactericidal compound preparation.