• 作者： 陳重華; 楊美鶴; 林景山; 李毓芹; 彭瑞鵬
• 作者服務機構： 台北榮民總醫院胸腔部
• 中文摘要： 雖已有報告beta-lactamase阻斷劑可增強Ampicillin或Amoxicillin對結核菌之體外抑菌效果。Beta-lactamase阻斷劑是否可增強頭抱子屬抗生素抗結核菌作用仍不可知，本報告試驗5種頭胞子屬抗生素，分別加入或不加入Sulbactam時對抗結核菌之最低抑菌濃度，且於試驗前偵測beta-lactamse之產生。 結果除4例於操作過程污染外，16株結核菌株皆可產生beta-lactamase， Ceforanide，Cephapirin， Cefamandole，Cefotaxime， Ceftriaxone對結核菌之最低抑菌濃度分別為200-400， 100-400， 400-1600， 200-1600， 800-1600 μg/ml。加入同莫耳數之Sulbactam後則變為100-200，12.5-100， 100-400， 25-200， 100-800 μg/ml之間，我們之結論乃Sulbactam確可增強頭抱子屬抗生素之抗結核菌作用。
• 英文摘要： Although there are reports that the addition of a beta-lactamase inhibitor to ampicillin or amoxicillingreatly improves their in vitro activity against M. tuberculosis, there are no written reports about the anti-tuberculosis effects of beta-lactamase inhibitors in combination with cephalosporins against M. tuberculosis. In this report, we have determined the minimal inhibitory concentrations (MIC) of 5 cephalosporinswith or without combination with beta-lactamase inhibitor against M. tuberculosis strains isolated frompatients before antituberculosis treatment and checked the production of beta-lactamase by bacteria beforethis procedure. Four strains of M. tuberculosis were contaminated during the experiment, and all the other 16 strainshydrolyzed the nitrocefin disc, thus indicating a beta-lactamase producer. The MICs of cephalosporinsalone against M. tuberculosis were 200-400 μg/ml for ceforanide, 100-400 μg/ml for cephapirin, 400-1600μg/ml for cefamandole, 200-1600 μg/ml for cefotaxime, and 800-1600 μg/ml for ceftriaxone. After addingthe equimolar concentrations of sulbactam, the MICs were reduced to 100-200 μg/ml for ceforanide, 12.5-100μg/ml for cephapirin, 100-400 μg/ml for cefamandole, 25-200 μg/ml for cefotaxime, and 100-800 μg/mlfor ceftriaxone. We concluded that sulbactam enhanced the antituberculosis effect of cephalosporins.
• 中文關鍵字： cephalosporin; minmal inhibtiory concertration; Mycobacterium tuberculosis.
• 英文關鍵字： --