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目的研究进口注射用克拉霉素与国产注射用乳糖酸红霉素对四川地区临床分离致病菌的体内、外抗菌活性。方法测定260株临床分离致病菌的最低抑菌浓度(MIC)、最低杀菌浓度(MBC),采用活菌计数法绘制杀菌曲线,并观察细菌接种量、培养基pH和血清蛋白含量对体外抗菌活性的影响,采用小鼠100%mLD菌量测定并计算ED50及95%可信限来观察注射用克拉霉素的体内抗菌活性。结果进口注射用克拉霉素MBC的浓度较其MIC的浓度高4～16倍,为抑菌剂;当接种菌量由5×103CFU·mL-1增至5×107CFU·mL-1时,进口注射用克拉霉素的MIC值增加2～4倍。pH偏碱,抗菌作用增强,尤以pH8～9时,抗菌作用明显增强,血清浓度75%时,抗菌作用有所减弱。进口注射用克拉霉素静脉给药,对敏感的金黄色葡萄球菌、化脓性链球菌和流感嗜血杆菌感染的小鼠具有保护作用,优于国产注射用乳糖酸红霉素。结论进口注射用克拉霉素比国产注射用乳糖酸红霉素具有更好的抗菌活性,可供临床参考。
Objective To study the in vitro and in vitro antibacterial activities of imported clarithromycin for injection and domestic erythromycin lactobionate on pathogens isolated from clinical isolates in Sichuan Province. Methods The minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBC) of 260 clinically isolated pathogens were determined. The bactericidal curves were drawn by viable count method and the in vitro antibacterial activity of inoculum, inoculation medium, Activity, the in vivo antibacterial activity of clarithromycin for injection was observed using a mouse 100% mLD assay and calculation of the ED50 and 95% confidence limits. Results The concentration of imported clarithromycin MBC was 4 to 16 times higher than that of MIC, and was a bacteriostatic agent. When the inoculum size increased from 5 × 103CFU · mL-1 to 5 × 107CFU · mL-1, the import MIC values for clarithromycin injection increased 2 to 4 times. The pH is slightly alkaline, and the antibacterial effect is enhanced. Especially at pH8 ~ 9, the antibacterial effect is obviously enhanced. When the serum concentration is 75%, the antibacterial effect is weakened. Imported clarithromycin intravenous injection for sensitive Staphylococcus aureus, Streptococcus pyogenes and Haemophilus influenzae infected mice have a protective effect, better than the domestic injection of erythromycin lactobionate. Conclusion Imported clarithromycin has better antibacterial activity than domestic injection of erythromycin lactobionate for clinical reference.