中华皮肤科杂志 ›› 2005, Vol. 38 ›› Issue (5): 282-284.

• 论著 • 上一篇    下一篇

不同抗菌药物体外对沙眼衣原体的单独和联合抗菌作用观察

尚淑贤, 夏隆庆, 邵长庚, 钟铭英, 张津萍, 赵建斌, 王千秋   

  1. 中国医学科学院、中国协和医科大学皮肤病研究所, 南京210042
  • 收稿日期:2004-08-26 出版日期:2005-05-15 发布日期:2005-05-15
  • 通讯作者: 王千秋,E-mail:wangqianqiu@china.com E-mail:wangqianqiu@china.com

In Vitro Effects of Various Antibiotics Alone and in Combination with Other Antibiotics against Chlamydia trachomatis

SHANG Shu-xian, XIA Long-qing, SHAO Chang-geng, ZHONG Ming-ying, ZHANG Jin-ping, ZHAO Jian-bin, WANG Qian-qiu   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
  • Received:2004-08-26 Online:2005-05-15 Published:2005-05-15

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摘要： 目的 观察大观霉素与头孢曲松体外对沙眼衣原体的单独抗菌作用以及分别与红霉素、氧氟沙星和多西环素的联合抗菌作用。方法 采用培养液稀释法测定抗菌药物体外单独对沙眼衣原体的抗菌作用,棋盘格稀释法研究抗菌药物体外联合后的相互作用情况。受试沙眼衣原体株总共12例,临床株10例,质控株2例。Ridit检验比较不同抗菌药物联合间的差异有统计学意义。结果 对沙眼衣原体而言,大观霉素与头孢曲松和几种抗菌药物体外联合后多数为无关作用。大观霉素与红霉素或多西环素联合时,分别有42%(5/12)和50%(6/12)的菌株表现出协同作用;头孢曲松与多西环素联合时8%(1/12)的菌株为拮抗作用;氧氟沙星与头孢曲松联合时8%(1/12)表现为协同作用。统计结果显示,与大观霉素或头孢曲松联合时,红霉素、氧氟沙星及多西环素三者之间差异无统计学意义(P值均>0.05)。与红霉素或多西环素联合时,大观霉素比头孢曲松更为有效,U值分别为2.46和2.83,P值均<0.5;与氧氟沙星联合时,大观霉素和头孢曲松之间差异无统计学意义(P>0.05)。结论 本研究结果提示大观霉素与红霉素或多西环素体外联合对沙眼衣原体能产生更好的协同作用。

关键词: 药物相互作用, 衣原体,沙眼, 抗生素类

Abstract: Objective To investigate the in vitro effects of various antibiotics (spectinomycin, ceftriaxone, erythromycin, ofloxacin and doxycycline) against 12 isolates of C. trachomatis. Methods Minimal inhibitory concentrations (MICs) and fractional inhibitory concentrations (FICs) of the antimicrobials against all C. trachomatis were calculated. Checkerboard method was used for the determination of FICs and Ridit test for the comparison of the interactions among the various combinations. Results No difference was observed in most of the combinations. No antagonism was found in all except for ceftriaxone-doxycycline combination. Synergism was observed in 42% (5 of 12) and 50% (6 of 12) of the chlamydial isolates for erythromycin-spectinomycin and doxycycline-spectinomycin combination, respectively. No significant difference was observed among triple combinations with spectinomycin or with ceftriaxone. When interactions of erythromycin, ofloxacin and doxycycline with spectinomycin were compared to those with ceftriaxone respectively, both interactions of erythromycin (U=2.46, P=0.014) and doxycycline (U=2.83, P=0.002) were more synergistic with spectinomycin than those with ceftriaxone. Conclusions This study indicates that the combination of spectinomycin with erythromycin or doxycycline is more effective against C. trachomatis than that of ceftriaxone. Therefore, spectinomycin rather than ceftriaxone might be recommended in the dual therapy against C. trachomatis and N. gonorrhoeae.

Key words: Chlamydia trachomatis, Antibiotics, Drug interactions