β-内酰胺类和大环内酯类抗生素联合应用的研究进展

Research progress of combination therapy of β-lactams and macrolides

β-内酰胺类与大环内酯类抗菌药物联合应用在治疗很多感染性疾病时疗效良好,近年来得到了较多的临床验证,国内外一些指导性文献均强调了这一新趋势。本文对β-内酰胺类与大环内酯类抗菌药物联合应用的理论依据及临床应用情况进行综述,表明这两类抗菌药物联用,可以扩大抗菌谱、降低耐药性;但与传统的快速杀菌剂和快速抑菌剂不能联用的理论相矛盾,且两类抗菌药物联用临床效果与体外实验结果难以取得一致,因此,两药联用的合理性还需更深入研究来验证。

Combination therapy of β-lactams and macrolides has got favorable therapeutic effect in the most of infection disease treatment.Some guiding publications in China and abroad both highlight the importance of this combination.We reviewed the theoretical principles and clinical status of combination therapy of β-lactams and macrolides.Although this treatment can extremely cover the main pathogenic bacteria,perhaps it is inconsistency with traditional pharmacology because the bacterial inhibitor may inhibit the bactericidal effects of rapid bactericidal agents.Several investigators tested the combination of β-lactams and macrolides in vitro and in vivo for antimicrobial activity against S.pneumoniae,but the results reported were not unified,and the rationality of the combination of β-lactams and macrolides should be proved with more evidences.