头孢布烯(Ceftibuten)体外抗菌作用

Comparative in vitro Activity of Ceftibuten

评价头孢布烯对临床分离的８３６株致病菌的体外抗菌作用。方法：头孢布烯与头孢克肟、头孢他啶、头孢噻肟、头孢呋辛、头孢克罗、头孢拉啶、环丙沙星进行比较。结果：头孢布烯对大多数革兰阴性菌具有很强的抗菌活性，如对大肠杆菌、肺炎克雷白杆菌、奇异变形杆菌、普通变形杆菌、沙门菌属、志贺菌属、粘质沙雷菌、阴沟肠杆菌的ＭＩＣ９０值均≤１ｍｇ·Ｌ－１，优于所测定的其他口服头孢菌素，与头孢他啶、头孢噻肟相似。头孢布烯对淋病奈瑟菌、流感嗜血杆菌也有很强的抗菌活性，但对某些肠杆菌科杆菌如弗劳地枸橼酸杆菌对本品与头孢他定相似不太敏感，ＭＩＣ９０值为８ｍｇ· Ｌ－１，乙酸钙不动杆菌对本品耐药， ＭＩＣ９０值为３２ ｍｇ·Ｌ－１。头孢布烯对革兰阳性菌除化脓性链球菌外作用均较弱。对肺炎链球菌的ＭＩＣ５０与ＭＩＣ９０值分别为２与４ｍｇ·Ｌ－１，不及其他所测定的三代头孢菌素。金黄色葡萄球菌、粪肠球菌、脆弱拟杆菌对头孢布烯耐药。从产酶大肠杆菌及肺炎克雷白菌的体外抗菌作用的结果表明，头孢布烯对产酶菌株具有较强的抗菌活性，ＭＩＣ９０值低于其他所测定的三代头孢菌素。结论：说明本品具有较强的β－内酰胺酶稳定性。细菌接种量、ｐＨ值的变化。

OBJECTIVE : By in vitro studies we evaluated the antimicrobial activity of ceftibuten (CTB). METHODS: Ceftibuten against 836 strains of pathogens were isolated from patients and compared with ceftazidime, cefotaxime, cefuroxime, cefaclor, cephradine and ciprofloxacin. RESULTS. The results showed that ceftibuten was more active than the other oral cephalosporins for most gram negative strains including E.coli, Klebsiella spp, Proteus mirabilis, Salmonella spp, Shigella spp, Serratia marcescens, Enterobacte cloacae (MIC90 ≤1 mg·L-1). The activity of cefibuten was equivalent to that of ceftazidime and cefotaxime against the above organisms. Cefibuten showed high activity against Neisseria gonorrhoeae and Haemophilus influenzae. Citrobacter freundii was less susceptible to both ceftibuten and ceftazidime (MIC90 8 mg·L-1). Acinetobacter calcoaceticus was resistant to ceftibuten (MIC90 32 mg·L-1). Ceftibuten showed mild activity against gram positive organism except Streptococcus pyogenes. The MIC50, and MIC90 of ceftibuten for Streptococcus pneumoniae were 2 mg·L-1 and 4 mg·L-1, respectively. Staphylococcus aureus, Enterococcus faecalis and Bacteroidfragilis were resistant to cetibuten.For E. coli and Klebsiella pneumoniae, MIC90 of ceftibuten were lower than that of the other third generation cephalosporins. CONCLUSION : The inoculum size, pH and concentration of serum protein did not influence the in vitro activity of ceftibuten.