国产磷酸克林霉素治疗细菌性感染安全性及有效性临床观察

磷酸克林霉素是克林霉素的酯化衍生物,供静脉用药。本品为林可霉素类抗菌素,主要用于治疗革兰氏阳性菌及厌氧菌感染。本项研究用国产磷酸克林霉素与进口磷酸克林霉素随机对照及开放治疗急性细菌性感染５２例,两药均每日静点２次,每次３００ｍｇ,疗程７～１４天。随机对照试验中,２０例国产磷酸克林霉素与２０例进口磷酸克林霉素总有效率分别为７５．０％与８０．０％,细菌清除率分别为８５．７％与９３．８％,不良反应发性率     

克林霉素预防术后感染98例的安全性调查

目的:了解克林霉素注射剂在预防术后感染中的安全性。方法:采用填写调查表和面访相结合的方式对我院应用克林霉素注射剂作术后预防用药的住院病人进行调查分析。结果:克林霉素预防术后感染98例,其中单用克林霉素51例(感染控制率100%),联用其他抗菌药物47例,共发生不良反应7例,主要为恶心、呕吐、腹泻、粒细胞减少、转氨酶升高等。结论:克林霉素可以用于术后感染的预防,应用时要注意剂量不宜过大,尽量采用单独用药,以避免或减少不良反应,增加用药的安全性。     

可诱导克林霉素耐药金黄色葡萄球菌医院感染分子流行病学调查

目的 了解我院金黄色葡萄球菌对红霉素及克林霉素的耐药性，测定红霉素对克林霉素诱导耐药率及诱导耐药基因。方法 双纸片法测定临床分离株红霉素对克林霉素的诱导耐药表型，聚合酶链反应检测诱导耐药基因。结果 94株金黄色葡萄球菌中有77株为红霉素耐药，其中结构型克林霉素耐药45株，诱导型耐药（D试验阳性）26株。51株MRSA中结构型耐药菌株占62．7％，D试验阳性菌株占19．6％。43株MSSA中结构型耐药菌株占30．2％，D试验阳性菌株占37．2％。克林霉素诱导型耐药主要由ermC基因决定。结论临床微生物实验室须加强可诱导克林霉素耐药的检测，以指导临床合理使用大环内酯类、林可酰胺类和链阳霉素B类抗生素。     

盐酸克林霉素氯化钠注射液中细菌内毒素定量检查(动态浊度法)方法的研究

应用动态浊度法鲎试验定量测定盐酸克林霉素氯化钠注射液中细菌内毒素含量.通过对样品进行干扰预试验,筛选出盐酸克林霉素氯化钠注射液最佳的检测浓度0.75mg·ml-1,进行正式干扰试验.样品中定量添加内毒素,10.00、1.00、0.10、0.01EU·ml-1,回收率为50%～200%,可用于有效的日常检查.     

Microbiological analysis of autologous bone particles obtained by low-speed drilling and treated with different decontamination agents

The aim of this study was to compare the effectiveness of three agents – two antibiotics (amoxicillin and clindamycin) and an antiseptic (chlorhexidine) – to decontaminate bone grafts obtained by low-speed drilling. The study included 248 bone tissue samples harvested from 62 patients by low-speed drilling before dental implant placement. Each of four samples obtained from every patient was dropped, using a sterile instrument, into a sterile tube containing a 500-μl solution of 400 μg/mL amoxicillin, 150 μg/mL clindamycin, 0.12% chlorhexidine, or physiological saline for 1 min. The number of colony-forming units (CFU) was determined at 48 h of culture. The use of clindamycin, amoxicillin, or chlorhexidine as decontaminant for 1 min significantly reduced the CFU count when compared to physiological saline (control agent). In both anaerobic and CO₂-rich atmospheres, significant differences in CFU/mL were found between the control and chlorhexidine groups (P < 0.001), control and amoxicillin groups (P < 0.001), control and clindamycin groups (P < 0.001), chlorhexidine and amoxicillin groups (P < 0.0001), and chlorhexidine and clindamycin groups (P < 0.0001). In conclusion, clindamycin had the highest decontaminating effect on bone particles obtained by low-speed drilling, followed by chlorhexidine and amoxicillin. Clindamycin may therefore be a valid alternative option for the routine decontamination of intraoral bone grafts.     

Chemical composition and evaluation of modulatory of the antibiotic activity from extract and essential oil of Myracrodruon urundeuva

Context: The combination of antibiotics with natural products has demonstrated promising synergistic effects in several therapeutic studies.

Objective: The aim of this study was to determine the effect of a combination of an ethanol extract of Myracrodruon urundeuva Fr. All. (Anacardiaceae) (aroeira plant) and its essential oil with six antimicrobial drugs against multiresistant strains of Staphylococcus aureus and Escherichia coli from clinical isolates.

Materials and methods: After identification of the chemical components by GC-MS, the antibacterial activity of the natural products and antibiotics was assessed by determining the minimal inhibitory concentration (MIC) using the microdilution method and concentrations ranging 8–512?μg/mL and 0.0012–2.5?mg/mL, respectively. Assays were performed to test for a possible synergistic action between the plant products and the antimicrobials, using the extract and the oil at a sub-inhibitory concentration (128?μg/mL) and antibiotic at concentrations varying between 8 and 512?μg/mL.

Results: The GC-MS analysis identified the main compound as δ-carene (80.41%). The MIC of the natural products was >1024?μg/mL, except against S. aureus ATCC25923. Only the combinations of the natural products with gentamicin, amikacin and clindamycin were effective against S. aureus 358, enhancing the antibiotic activity by reducing the MIC.

Conclusions: The extract from aroeira showed a higher antibacterial activity and the oil was more effective in potentiating the activity of conventional antibiotics.     

The pulsed‐dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single‐blinded trial

Background Acne vulgaris is the most common skin disease and can pose a substantial therapeutic challenge. Recently, several phototherapeutic modalities, most notably pulsed‐dye laser (PDL) treatment, have been introduced, but the published results – albeit promising – are controversial. Objectives To assess the efficacy of an adjuvant PDL treatment when combined with a proven topical treatment [fixed‐combination clindamycin 1%–benzoyl peroxide 5% hydrating gel (C/BPO)]. Methods Eighty patients (38 males and 42 females, mean ± SD age 19·7 ± 5·9 years) were randomized in a 1 : 2 ratio to receive C/BPO alone or in combination with PDL treatment (wavelength 585 nm, energy fluence 3 J cm⁻², pulse duration 0·35 ms, spot size 7 mm). Patients were evaluated at baseline and at 2 and 4 weeks after initial treatment. The primary end points were the Investigator’s Static Global Assessment (ISGA) score and lesion count; the secondary end point was the Dermatology Life Quality Index (DLQI). Results Both groups showed a significant improvement during observation [ISGA 27·1% (C/BPO) and 24·6% (C/BPO + laser), total lesion count 9·2% and 9·0%, inflammatory lesion count 36·3% and 36·9%, DLQI 54·5% and 42·5%], but there was no significant or otherwise appreciable difference between treatment modalities as far as the extent of improvement was concerned. Patients with more severe findings at baseline had a greater benefit from either therapy regimen. Conclusions Our findings do not support the concept of a substantial benefit of PDL treatment in acne vulgaris.     

Significance of MRSA strains in community associated skin and soft tissue infections

The study was conducted to determine the antibiotic susceptibility profile of community-associated methicillin resistant Staphylococcus aureus (CAMRSA) strains isolated from infections. S. aureus strains were isolated from clinical specimens using the standard procedures. CDC definition was used to classify CAMRSA. Antibiotic susceptibility test was done using Kirby-Bauer disk diffusion method. Double disk diffusion method (D-test) was used to detect inducible macrolide, lincosamide and streptogramin_B resistance (inducible MLS_B resistance). A total of 83 CAMRSA were isolated from abscesses and other skin infections in persons without known risk factors for MRSA infection. All CAMRSA were susceptible to vancomycin. Out of 83 CAMRSA, 13 (15.65%) were D-test positive (inducible MLS_B positive) and 6 (7.23%) were positive for constitutive MLS_B resistance. Eight strains (9.63%) were resistant to tetracycline and 26 (31.32%) strains were resistant to erythromycin. Increased rate of inducible clindamycin resistance among CAMRSA indicates the importance of identification of such strains by D test to avoid treatment failure when clindamycin is used.     

反相高效液相色谱法测定人血浆中克林霉素浓度

目的建立反相高效液相色谱法测定人血浆中克林霉素浓度的方法。方法采用反相高效液相色谱法，NUCLEODUR C18柱（150mm×4．6mm，5μm），流动相为乙腈-四氢呋喃-磷酸缓冲液（27：1：72），流速：1mL·min^-1，测定波长：204nm。结果克林霉素最低定量浓度为0．05μg·mL^-1，线性范围为0．05-16μg·mL^-1（r=0．9983），方法回收率均〉95％。日内、日间精密度（RSD）〈10%。结论该方法快速、简便、无杂质干扰，适用于克林霉素的体内药物浓度测定及药动学研究。