DRUG RESISTANCE AND COMBINATION EFFECT OF β-LACTAMS AGAINST CLINICAL ISOLATES OF METHICILLIN-RESISTANT <I>STAPHYLOCOCCUS AUREUS</I>
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The effect of different 2 -drug combinations among β-lactams were examined in vitro against 17 clinical isolates of methicillin-resistant <I>staphylococcus aureus</I> (MRSA) in surgical inpatients.<BR>In 12 combinations of group A (ampicillin, ABPC ; cefazolin, CEZ ; cefotiam, CTM) and group B (imipenem, IPM; flomoxef, FMOX ; cefmetazole, CMZ), and fosfomycin (FOM) and group B, the strong synergistic activity (FIC index≤0.5) was found in 17 strains (100%) among combinations of CTM and FMOX, and CTM and CMZ. In 16 strains (94.1%) among CEZ and CMZ, and in 14 strains (82.4%) among CEZ and FMOX.<BR>The mean FIC index of 17 strains was 0.220 (CTM+CMZ), 0.256 (CTM+IPM), 0.265 (CEZ+CMZ) and 0.291 (CTM+FMOX). They have shown good synergistic activity against MRSA strains. Relationship between mean MICs of each drug and those of effective plasmalevels was investigated and the following results were observed. For all 12 combinations, mean MICs of at least one of two drugs were below the effective plasma levels. Above all, in the combinations of ABPC and CMZ, CEZ and IPM, and CTM and IPM, the mean MICs were markedly decreased.<BR>It can be therefore concluded that these in vitro results suggest the expectation of sufficient clinical effects.
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北関東医学会 | 論文
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