批准用于奶牛的抗菌药物分析

我国奶牛养殖规模不断扩大,奶业产值比重逐步提高,给奶牛疫病防治带来巨大压力。奶牛乳房炎及细菌性肺炎等呼吸系统疾病和细菌性肠炎等消化系统疾病最为常见,抗菌药物的使用成为主要防治手段。但抗菌药物的不当使用易使细菌产生耐药性,增加临床治疗的成本和难度,危害我国奶牛产业发展。本文对截至2021年7月我国和美国、英国、日本、欧盟批准用于奶牛的抗菌药物产品进行整理、统计与分析,包括抗菌药物的分类、剂型以及适应证等,旨在为我国奶牛用抗菌药物管理、合理用药和新兽药开发提供参考。     

Therapeutic effect of antimicrobial drugs against experimental infections due toYersinia pestis in mice

Although there are effective antibacterial agents against plague, newer antibacterial agents have been developed which show more potent activity against other bacterial organisms, but have not been tested againstYersinia pestis. A strain ofYersinia pestis was selected (no. 22; National Institute of Infectious Diseases, Tokyo, Japan) that caused a systemic infection in mice.Y. pestis no. 22 was intraperitoneally inoculated into DDY-strain mice, and 13 oral or 6 injectable antibacterial drugs given to the infected mice at varying doses 1 and 24 hours after infection. Levofloxacin, sparfloxacin and ofloxacin were the most effective oral agents against the infection, and prulifloxacin and pazufloxacin were also effective but to a lesser extent. Also, gentamicin and arbekacin were the most potent injectable antibacterial agents againstY. pestis. These results suggest that there are several new drugs, both oral and injectable, which exert excellent in vivo antibacterial activity against a mouse infection model and may be useful for the clinical treatment of plague.     

Chlorhexidine compared with other locally delivered antimicrobials

Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment. In supragingival plaque control regimens, chlorhexidine has not been superceded as a chemical anti-plaque agent, although other compounds have been shown to be useful. The local side-effects of chlorhexidine and other cationic antiseptics, however, limit their long-term use for prevention. Extrinsic tooth staining in particular remains the greatest problem. Short-term anti-plaque uses for chlorhexidine include as an adjunct to mechanical cleaning in the initial oral hygiene phase of treatment, in situations where mechanical oral hygiene is difficult, including postsurgery, intermaxillary fixation, fixed orthodontic therapy, physically and mentally handicapped individuals, systemic diseases with oral manifestations such as leukaemia. More recent interest in chlorhexidine has resulted from the delivery of compounds subgingivally in the treatment of chronic periodontitis. Such methods have extended the use of chlorhexidine into areas inaccessible to the action of antimicrobial drugs delivered locally by conventional means, such as tooth brushing or mouth rinsing. Available evidence suggests that chlorhexidine may not be as effective as some antimicrobial drugs whose activity is more specific for those organisms considered particularly pathogenic to the periodontal tissues.     

抗菌药物的药动学及药效学相关研究的临床意义

通过对抗菌药物的药动学(PK)、药效学(PD)的相关研究，发现了抗菌药物不同的PK/PD特性；提出了预测抗菌药物疗效的重要PD参数为AUC0-24/MIC，Cmax/MIC，t＞MIC和抗生素后效应(PAE)等；而且对评价药物有效性。指导合理用药，提高药物疗效，避免产生耐药性都有指导性的作用。因此，PK/PD研究是抗菌药合理应用的基础，在研究、设计和制定抗菌药物治疗方案、制定敏感性临界值以及推荐用药指南等方面都具有重要价值。     

2000年～2003年我院抗微生物药物应用分析

目的 :了解我院抗微生物药物应用情况及使用趋势。方法 :收集我院 2 0 0 0年～ 2 0 0 3年抗微生物药物入库记录 ,采用Excel进行统计分析。结果 :2 0 0 3年我院抗微生物药物的金额、高档抗微生物药物的使用频率较前 3年有较大增幅 ;较常应用的抗微生物药物为头孢菌素类、青霉素类、喹诺酮类 ;大多数药物的日治疗费用呈逐年降低趋势。结论 :我院使用抗微生物药物结构基本合理 ,但还需加强宏观管理。     

阴道来源的乳杆菌抑菌物质研究进展

乳杆菌是大多数健康女性阴道微生态中的优势菌群,对预防泌尿生殖系统感染性疾病起重要作用。能产生乳酸、过氧化氢、细菌素和生物表面活性物质等抑菌物质是乳杆菌成为潜在益生菌的重要基础。本文对阴道来源的乳杆菌抑菌物质相关研究进展作一综述。     

In vitro efficacy of various topical antimicrobial agents in different time periods from contamination to application against 6 multidrug-resistant bacterial strains isolated from burn patients

Aim

In vitro efficacy evaluation of eleven topical antimicrobials against multidrug-resistant (MDR) bacteria isolated from burn wounds of our patients.

Material and methods

Growth of six MDR bacterial strains: Pseudomonas aeruginosa (2 strains), Staphylococcus aureus, Staphylococcus haemolyticus, Enterococcus faecalis and Escherichia coli in burn-wound models was evaluated 24-h after application of the tested agents. Four different wound models were created to investigate the role of time elapsed between inoculation of bacteria and application of the agents on their antimicrobial activity and efficacy.

Results

The efficacy against all the 6 bacteria in freshly contaminated wounds was excellent in majority of the tested agents. The longer was the time interval between inoculation and application of the topical antimicrobial agents, the higher failure of the agents was observed.

Conclusions

Topical antimicrobials play an important role in treatment of burn wounds, but they should be used according to their efficacy against bacterial strains present in patients’ wounds. In cases where topical agents have been applied after 24 h, when formation of mature biofilm in the wound could be expected, it would probably not be possible to kill all the bacteria using topical antimicrobial therapy only.     

抗菌药物专项整治对我院门诊抗菌药物处方质量影响分析

目的评价抗菌药物专项整治活动对规范我院抗菌药物使用的效果,为进一步加强抗菌药物临床应用管理提供参考。方法随机抽取2012年3月-2012年9月（整治前）以及2012年9月-2013年2月（整治后）我院门诊抗菌药物处方各1 037张,对整治前后门诊抗菌药使用情况进行比较。结果不合理用药处方由整治前531张（51.21%）下降至260张（25.07%）;整治后第一、第二代头孢菌素使用率明显上升,第三、第四代头孢菌素及喹诺酮类使用率下降;口服剂型使用率由32.79%上升到53.42%,注射剂使用率由67.21%下降到46.58%,处方平均金额下降,使用药物的品种减少,抗菌药药物联用比例下降。整治前后比较差异具有统计学意义（P〈0.05或P〈0.01）。结论抗菌药物整治工作有助于促进抗菌药物的合理使用,督促临床重视安全、合理和经济地使用抗菌药物。