司帕沙星与其他5中抗菌药体外抗菌活性比较研究

测定了司帕沙星对临床分离的１９９株致病菌的休外抗菌活性并与氧氟水利生、环丙沙星、头孢唑啉、头孢噻肟、阿米瞳星的抗菌活性进行比较。司帕沙星对革兰阳性菌的ＭＩＣ９０为０．１２５￣０．５ｍｇ／Ｌ,对金葡球菌、化脓链球菌的抑菌率均为１００％,强于氧氟沙星、环丙沙星;对革兰阴性菌也具有良好的体外抗菌活性,与氧氟沙星、环丙沙星相似。不同细菌接种量和不同浓度血清对其抗菌活性无明显影响,仅在ｐＨ５．０时抗菌活性略     

司帕沙星和妥舒沙星的体内外抗菌作用研究

目的观察国产司帕沙星、妥舒沙星及其它四种氟喹诺酮类抗菌药对成都地区780株临床分离菌的体外抗菌活性，并比较司帕沙星、妥舒沙星和环丙沙星对金葡球菌、大肠埃希菌和铜绿假单胞菌感染小鼠的体内抗菌活性。方法用琼脂稀释法测定国产司帕沙星和妥舒沙星的MIC50和MIC90，并与其它四种氟喹诺酮类抗菌药进行了比较。本文还测定了抗菌药对金葡球菌、大肠埃希菌和铜绿假单胞菌感染小鼠治疗的ED50结果体外试验表明司帕沙星和妥舒沙星能有效抑制或杀灭革兰阳性、革兰阴性菌及厌氧菌，显示了广谱抗菌活性。司帕沙星和妥舒沙星对革兰阳性菌的抗菌活性是环丙沙星的2～8倍，氧氟沙星和氟罗沙星的4～16倍，是诺氟沙星的16～32倍。司帕沙星对MRSA的抗菌活性与妥舒沙星相似，但优于环丙沙星、氧氟沙星、氟罗沙星和诺氟沙星。司帕沙星对大多数革兰阴性菌的抗菌活性与环丙沙星和妥舒沙星相似，是氧氟沙星、氟罗沙星和诺氟沙星的2～8倍。两药对厌氧菌的抗菌活性也较环丙沙星强。口服或皮下注射司帕沙星对金葡球菌和大肠埃希菌所致小鼠全身性感染的保护作用优于环丙沙星和妥舒沙星。同一给药途径下司帕沙星对铜绿假单胞菌所致小鼠全身性感染的保护作用与妥舒沙星和环丙沙星相似。三种受试药对金葡球菌和大肠埃希菌所致小鼠全身性感染的保护作用优于铜绿假单胞菌所致感染。结论司帕沙星和妥舒沙星对革兰阳性菌和厌氧菌的体外抗菌活性优于环丙沙星和其它药物，对大多数革兰阴性菌的抗菌活性与环丙沙星相似，但优于其它受试药。司帕沙星对金葡球菌和大肠埃希菌所致小鼠全身性感染的体内保护作用优于环丙沙星和妥舒沙星。同一给药途径下司帕沙星对铜绿假单胞菌所致小鼠全身性感染的保护作用与妥舒沙星和环丙沙星相似。     

新喹诺酮类抗菌药司帕沙星随机对照治疗呼吸系统感染的临床研究

司帕沙星（ｓｐａｒｆｌｏｘａｃｉｎ,ＳＰＬＸ）是一新喹诺酮类抗菌药物。本试验采取随机对照方法,评价了司帕沙星治疗呼吸系统感染的有效性与安全性,选用氧氟沙星为对照。两组共治疗患者８０例,每组各４０例。结果显示,司帕沙星组与氧氟沙星组有效率分别为８７．５％和８５％,细菌清除率分别为８６．１％与８６．１％,不良反应发生率分别为７．５％和１０％,以上结果统计学均无显著性差异（Ｐ＞０．０５）。司帕沙星与氧氟沙星等６种抗菌药物的体外抗菌活性比较显示,司帕沙星对革兰氏阳性菌的ＭＩＣ９０值≤０．２５ｍｇ／Ｌ,体外抗菌活性高于氧氟沙星;对大多数革兰氏阴性菌具有良好的体外抗菌活性,与氧氟沙星相似。试验表明,司帕沙星是一个高效、安全的抗菌药物,治疗呼吸系统感染疗效肯定。     

国产司帕沙星治疗急性呼吸道感染的多中心临床对照试验

司帕沙星（ｓｐａｒｆｌｏｘａｃｉｎ）是一广谱长效的新型氟喹诺酮类抗菌药。本试验采取多中心随机对照方法，评价了司帕沙星治疗呼吸系统感染的有效性与安全性，选用环丙沙星为对照。两组共治疗患者１２４例，其中司帕沙星组６５例，环丙沙星组５９例。结果显示：司帕沙星对呼吸系统感染的疗效明显优于环丙沙星，统计学有显著性差异（Ｐ＝ ０．０３３），司帕沙星组与环丙沙星组的有效率分别为９２．３％ 和８３．１％ ；两组清除率分别为９２％ 和７８．３％ ；不良反应发生率分别为７．７％ （５／６５）和１３．６％ （８／５９）。试验表明：司帕沙星是一抗菌谱广、抗菌活性强、临床疗效好、不良反应发生少而轻微、服用方便的抗菌药物，对呼吸系统感染疗效肯定确切。     

新型高效广谱抗菌药物——安妥沙星

安妥沙星具有广谱的抗菌作用,对革兰阴性菌包括流感嗜血杆菌、克雷伯菌、变形杆菌、不动杆菌、沙门菌属等具有良好的抗菌活性,抗菌作用优于环丙沙星、氧氟沙星、司巴沙星和洛美沙星;对革兰阳性球菌包括溶血性链球菌等也具有较好的抗菌作用,特别是对甲氧西林耐药的葡萄球菌,其抗菌活性较环丙沙星、氧氟沙星、司巴沙星和洛美沙星强8～16倍;对厌氧菌以及分枝杆菌也有一定的抗菌活性。动物体内保护试验结果证明安妥沙星的作用与左氧氟沙星、氧氟沙星和环丙沙星相当或略强。临床研究结果表明,安妥沙星在正常受试者中耐受性良好,在首次0．4g,以后每次0．2g,一日1次给药剂量下,治疗轻、中度急性细菌性感染包括呼吸系统感染、泌尿系统感染、皮肤软组织感染具有良好的安全性和有效性。     

巴洛沙星的体外抗菌作用研究

目的考察巴洛沙星的体外抗菌作用。方法以琼脂稀释法测定巴洛沙星对临床分离致病菌的最低抑菌浓度，并与诺氟沙星、氧氟沙星、环丙沙星、妥舒沙星和洛美沙星等抗菌药进行比较；测定巴洛沙星的杀菌作用，观察巴洛沙星的抗菌活性。结果 巴洛沙星对革兰阳性菌和革兰阴性菌具有广谱抗菌活性，尤其对金黄色葡萄球菌、肺炎球菌、肠球菌等革兰阳性菌的活性优于诺氟沙星、氧氟沙星和环丙沙星。巴洛沙星有较强的杀菌作用，其MBC与MIC相近，在体外具有较长时间的抗菌后效应。结论巴洛沙星是一种广谱抗菌药，抗菌作用强，有一定的临床应用前景。     

Du6859a及其他新的氟喹诺酮类药物的体外抗菌活性

用琼脂稀释法测定Ｄｕ６８５９ａ对１２０６株临床分离菌的抗菌作用，并与其同类品种（司帕沙星、托舒沙星、诺氟沙星、氧氟沙星、左氟沙星、环丙沙星）比较。Ｄｕ６８５ｑａ对金葡球菌不产酶株、ＭＳＳＡ、ＭＲＳＡ、ＭＲＳＥ，溶血性链球菌和肺炎球菌的ＭＩＣ＿（９０）均为０．５ｍｇ／Ｌ；对肠球菌的ＭＩＣ＿（９０）为２ｍｇ／Ｌ，优于其同类品种。多数肠杆菌科细菌可为０．２５ｍｇ／Ｌ，铜绿假单胞菌可为０．５ｍｇ／Ｌ的本品所抑制，其抗菌活性与司帕沙星和托舒沙星相似。Ｄｕ６８５９ａ对各种厌氧菌亦具良好作用，多数菌株可为０．５ｍｇ／Ｌ的浓度抑制。因此认为本品具有良好的临床应用前景，值得进一步临床试验。     

帕珠沙星对临床分离致病菌的体外抗菌活性研究

目的评价帕珠沙星的体外抗菌活性。方法采用琼脂二倍稀释法，测定帕珠沙星与左氧氟沙星对342株临床分离菌株的最低抑菌浓度（MIC）。结果帕珠沙星对革兰阴性菌和革兰阳性菌的MIC90分别为0．06～4和1～16μg／ml。对大肠埃希菌、阴沟肠杆菌、变形菌、铜绿假单胞菌、不动杆菌和链球菌的MIC90为0．06～4μg／ml，是左氧氟沙星的1／2～1／8;对肺炎克雷伯菌、金葡菌和表葡菌与左氧氟沙星抗菌作用相当，MIC90分别为0．5、1、1μg／ml；对流感嗜血杆菌、黏膜炎莫拉菌和粪肠球菌的MIC90为0．5、1、16μg／ml，高于左氧氟沙星（0．25、0．5、8μg／ml）。结论帕珠沙星对革兰阴性菌和革兰阳性菌均具有广谱的抗菌作用，对革兰阴性菌的抗菌活性优于革兰阳性菌。     

20-48 曲伐沙星与其它5种喹诺酮类药物体外抗菌活性的比较

Montanari等比较了曲伐沙星及其它5种喹诺酮类抗菌药(环丙沙星、氧氟沙星、培氟沙星、芦氟沙星、司帕沙星)的体外抗菌活性.所用650株革兰氏阳性和阴性需氧菌是从意大利医院分离的各种病原菌.结果显示,曲伐沙星对革兰氏阳性菌的活性高于其它受试     

喹诺酮类药物对豚鼠心电图的影响

目的　观察比较环丙沙星、左氧氟沙星和司帕沙星的心脏毒性。方法　记录腹腔给药后豚鼠心电图 ,探讨对心电图各项指标的影响。结果　环丙沙星、左氧氟沙星及司帕沙星均能引起豚鼠心电图异常 ,出现 QT间期显著延长、室性早搏、房室传导阻滞等 ,而其他指标未见显著改变。在同等剂量下 ,左氧氟沙星对心电图影响最小 ,环丙沙星与左氧氟沙星接近 ,而司帕沙星而对心电图影响最大。结论　环丙沙星、左氧氟沙星及司帕沙星均可引起豚鼠心电图改变 ,但左氧氟沙星及环丙沙星的作用低于司帕沙星。     

妥舒沙星的体内外抗菌作用研究

测定妥舒沙星的体内外抗菌活性。以同类氟喹诺酮类及其他抗菌药物为对照,测定了６８９株临床分离菌对药物的敏感性,结果显示,妥舒沙星对需氧革兰氏阳性球菌（除ＭＲＳＡ外）均有良好的抗菌作用,对金葡球菌、肺炎球菌和溶血性链球菌的抗菌活性高;妥舒沙星对需氧革兰氏阴性菌具强大的抗菌作用,对肠杆菌科细菌、流感杆菌和淋球菌的抗菌作用尤强;妥舒沙星对脆弱拟杆菌等厌氧菌亦具良好抗菌作用。妥舒沙星对需氧革兰氏阳性球菌及厌氧菌的作用明显优于环丙沙星、氧氟沙星和诺氟沙星,对需氧革兰氏阴性杆菌的作用与其他受试氟喹诺酮类相仿。妥舒沙星对小鼠实验性细菌感染具有明显保护作用,口服或静注妥舒沙星对金葡球菌的体内抗菌作用明显优于环丙沙星;对大肠埃希氏菌的抗菌作用优于或与环丙沙星相似;对铜绿假单胞菌的作用与环丙沙星相似。     

甲磺酸加替沙星与其他4种氟喹诺酮类药物对临床分离菌的体外抗菌活性比较

目的 :比较甲磺酸加替沙星与氧氟沙星、左氧沙星、环丙沙星、司帕沙星对 182株临床分离菌的体外抗菌活性。方法 :采用琼脂平板二倍稀释法测定加替沙星等 5种氟喹诺酮类药物对 182株临床试验分离菌株的最低抑菌浓度 (MIC)。结果 :加替沙星对葡萄球菌属的MIC90 比其他 4种氟喹诺酮类药物低。葡萄球菌属对加替沙星的敏感率显著高于其他4种氟喹诺酮类药物 ;对其他G 球菌的MICR 也较其他氟喹诺酮类药物低。G-杆菌中埃希菌属、肠杆菌属对加替沙星的敏感率明显高于其他 4种氟喹诺酮类药物 ,加替沙星对埃希菌属、肠杆菌属的MIC90比左氧沙星低 2倍 ,比其他 3种抗菌药物低 8倍 ;假单胞菌属、克雷伯菌属和其他G-杆菌对加替沙星的敏感率与左氧沙星的差异无统计学意义 ,与其他 3种氟喹诺酮类药物的差异有统计学意义。结论 :甲磺酸加替沙星具有广谱而强大的体外抗菌活性。     

In vitro activities of LB20304, a new fluoroquinolone

Thein vitro activity of LB20304 was evaluated against clinical isolates and compared with those of Q-35, ciprofloxacin, sparfloxacin, lomefloxacin and ofloxacin. LB20304 demonstrated 16- to 64-fold more potent activity than ciprofloxacin against gram-positive bacteria. LB20304 inhibited 90% of the isolates of methicillin-susceptibleStaphylococcus aureus (MSSA) at a concentration of 0.016 μg/ml (MIC₉₀). MIC₉₀ values of LB20304 against methicillin-resistantStaphylococcus aureus (MRSA), methicillin-susceptibleStaphylococcus epidermidis (MSSE), methicillin-resistantS. epidermidis (MRSE) andStreptococcus pneumoniae were 2 μg/ml, 0.016 μg/ml, 0.5 μg/ml and 0.031 μg/ml, respectively. LB20304 was also very active against gram-negative bacteria. AgainstEscherichia coli, Klebsiella pneumoniae, Serratia marcescens, Pseudomonas aeruginosa andAcinetobacter calcoaceticus, MIC₉₀S of LB20304 were 0.031 μg/ml, 0.25 μg/ml, 2 μg/ml, 8 μg/ml and 0.5 μg/ml, respectively. Its activity was comparable to that of ciprofloxacin but much better than those of Q-35, sparfloxacin, ofloxacin and lomefloxacin. LB20304 also exhibited the most potent activity among quinolones tested against laboratory standard strains, ofloxacin-resistant strains, β-lactamase-producing strains and anaerobic strains. The inhibitory effect (IC₅₀) of LB20304 on DNA gyrase fromMicrococcus luteus, determined by the supercoiling assay, was 8-fold more potent than that of ciprofloxacin. LB20304 did not induce topoisomerase-associated DNA cleavage even at a concentration of 10 mg/ml, although ciprofloxacin induced DNA cleavage at a concentration of 1 mg/ml.     

The bactericidal activity of levofloxacin against ampicillin-resistant and ampicillin-susceptible Haemophilus influenzae in comparison with ofloxacin, ciprofloxacin and sparfloxacin

The bactericidal activity of levofloxacin against four Haemophilus influenzae clinical isolates (two ampicillin-resistant and two susceptible) was compared with that of ofloxacin, ciprofloxacin and sparfloxacin at concentrations simulating the peak serum concentrations obtained with the recommended oral doses. Bactericidal activity was assessed using time-kill curves and minimum kill-time values. Both concentrations of levofloxacin rapidly killed all the study strains, with mean kill times of 4 h and no viable bacteria remaining after 18-h exposure. The bactericidal activities of levofloxacin, ofloxacin and sparfloxacin were similar. The minimum kill-times for both concentrations of ciprofloxacin were 28-35% longer than those of levofloxacin. These results support the use of levofloxacin for H. influenzae infections, including ampicillin-resistant strains.     

Febrile neutropenia in a bone marrow transplantation unit

A total of 119 strains of coagulase-negative staphylococci isolated from clinical specimens were speciated and tested for sensitivity to methicillin and four fluoroquinolones (ciprofloxacin, sparfloxacin, levofloxacin and ofloxacin). Resistance to fluoroquinolones was significantly more common in Staphylococcus haemolyticus (43%) than in Staphylococcus epidermidis (11%). Methicillin-resistant strains of S. haemolyticus were more often resistant to ciprofloxacin than were methicillin-resistant strains of S. epidermidis (P < 0.05). Sparfloxacin was the most active against fluoroquinolone-sensitive strains, and levofloxacin was twice as active as ofloxacin. There was cross-resistance between the four fluoroquinolones. Levofloxacin was the most active against resistant strains, but MICs obtained for all the compounds seemed to be outside the clinically useful range for the treatment of systemic infections.     

6种氟喹诺酮类药物对临床分离金葡萄的抗菌活性比较

目的：观察临床分离金葡萄对6种氟喹诺酮类药物的耐药情况。方法：用琼脂稀释法测定诺氟沙星（NFLX）、氧氟沙星（OFLX）、氟罗沙星（FLRX）、环丙沙星（CPFX）、司帕沙星（SPFX）、托舒沙星（TFLX）6种2、3代氟喹诺桐类药物对成都地区155株临床分离金葡菌的体外抗菌活性。结果：金葡菌对6种药物的耐药率分别为诺氟沙星35.5%。氟罗沙星34.19%,环丙沙星27.75%,托舒沙星27.75% ,氧氟沙星25.81%,司帕沙星25.81%。结论：氟喹诺酮类药物的广泛应用已使细菌的耐药性明显增高,各药MIC90均超过16mg.L^-1,比以往文献报道的本地区金葡萄耐药性明显升高,提示要合理应用氟喹诺酮类药物,减少耐药菌株的增加。     

The importance of active efflux systems in the quinolone resistance of clinical isolates of Salmonella spp

The aim of this study was to determine the importance of the active elimination of antibiotics by active efflux systems, in the decrease in fluoroquinolone sensitivity of clinical isolates of Salmonella spp. as well as the intrinsic antibiotic activity of certain active efflux system inhibitors. The effect of the active efflux system on the decrease in sensitivity to nalidixic acid, ciprofloxacin, ofloxacin and sparfloxacin was studied by investigating the variation in the in vitro activity of these compounds when assayed in association with reserpine and MC 207.110. The active efflux systems inhibited by reserpine displayed low activity in the elimination of these compounds, whereas those inhibited by MC 207.110 showed high activity in the elimination of nalidixic acid and sparfloxacin, but were less effective in the elimination of ofloxacin and ciprofloxacin. These two compounds did not exhibit intrinsic inhibitory activity against Salmonella spp. at the concentrations assayed. These mechanisms of resistance to antibiotics are complex and vary depending on the chemical composition of the antibiotics used, and perhaps the inhibitors of these systems, although they do not exhibit any intrinsic antibiotic activity, may be used as adjuvants to increase the activity of certain antibiotics. These mechanisms complement the mutations in the gyrA gene and this supports the thesis that it is necessary to lower the breakpoint established by the NCCLS for ciprofloxacin, since the strains studied have resistance mechanisms that reduce the activity of this drug and may favour the emergence of resistant mutants during treatment.     

Comparative activities of six different fluoroquinolones against 9,682 clinical bacterial isolates from 20 European university hospitals participating in the European SENTRY surveillance programme

The in-vitro activities of gatifloxacin, trovafloxacin, levofloxacin, sparfloxacin, ofloxacin, and ciprofloxacin were tested against 9,682 clinical bacterial isolates from 20 European university hospitals participating in the European SENTRY surveillance programme. Gatifloxacin and trovafloxacin exhibited the highest activities against Gram-positive cocci, while levofloxacin, ofloxacin, ciprofloxacin, and gatifloxacin were the most active against Enterobacteriaceae. Ciprofloxacin and levofloxacin showed the highest antimicrobial activities against Pseudomonas spp., while gatifloxacin and trovafloxacin were the most active against Acinetobacter spp. and Stenotrophomonas maltophilia. All Haemophilus spp. and Moraxella catarrhalis isolates were fully susceptible to all quinolones tested. Overall, the new quinolones, showed improved activity against Gram-positive cocci and Gram-negative non-fermenters while retaining their broad-spectrum activity against Gram-negative bacilli.     

In vitro method for prediction of the phototoxic potentials of fluoroquinolones

The phototoxic potential of eight fluoroquinolones (norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin and gatifloxacin) was evaluated by using three in vitro methods of cytotoxicity against mammalian cells, erythrocyte lysis and DNA strand breakage. All fluoroquinolones tested with the exception of gatifloxacin, an 8-methoxy quinolone, showed DNA strand breaking activities under UV-A irradiation. Their cytotoxicity against HeLa cells was also enhanced by UV-A irradiation. In particular, the phototoxic potential of sparfloxacin, enoxacin and lomefloxacin was high in both methods. Ofloxacin is very photocytotoxic against HeLa cells, while it has low potential to cause DNA strand breakage. Norfloxacin, ciprofloxacin and enoxacin were very photohemolytic, but sparfloxacin was not, indicating that the in vivo phototoxic potencies of fluoroquinolones might not be predictable by the photohemolysis study. Gatifloxacin, a non-phototoxic quinolone, showed no phototoxic potential in any of these three in vitro tests. These results suggest that determination of DNA strand breaking activity, combined with cytotoxicity against mammalian cells, is available to predict the phototoxic potential of fluoroquinolones without laboratory animals.     

Uptake of Fluoroquinolones in Human Monocytes Isolated from Peripheral Blood

The aim of this study was to develop a technique for separating monocytic cells in suspension from peripheral blood to measure the intracellular penetration of three fluoroquinolones (ofloxacin, ciprofloxacin and sparfloxacin). Mononucleated cells were isolated from the blood on a density gradient with lymphoprep and purified by a specific technique of adhesion and disadhesion on fibronectin. The monocytes were obtained in suspension with 76.8% purity and 97.9% viability. This was a convenient form for measurement of intracellular accumulation by use of the velocity-centrifugation technique. Intra-monocytic penetration of ciprofloxacin, ofloxacin and sparfloxacin was measured at equilibrium after 30-min incubation in the presence of 16 μg mL^?1 antibiotic. The results revealed low intra-monocytic accumulation of ciprofloxacin (intracellular-extracellular = 1.76) and ofloxacin (intracellular-extracellular = 1.42). The penetration of sparfloxacin was significantly higher (intracellular-extracellular = 2.4). This study confirms the important differences between human immunocompetent cells in terms of their ability to concentrate quinolones. It also underlines the importance of monocyte-macrophage cellular differentiation as a determinant of antibiotic penetration.