New Antibiotics Their Role in the Treatment of Infection - 1/p.25-35.pdfNew Antibiotics Their Role...
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New Antibiotics Their Role in the Treatment of Infection
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epidermidis.
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plasmid, chromosome V\1€l transposon. b'5wnrJii~tln~~'il €l11l€l~U€lm'1fG'l~V\1€l€l~lUb'1fG'l~~U1b1 ill'li€l-J periplasmic~ bb G'l~ €lH ~n~ ~'il€l€ln:lJ1bUU ~lU1U:lJ1n (constitutive) V\1 €l~€l-J ~n
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29 J Infect Dis Antimicrob Agents Vol 5 No.1 Jan. - Mar. 1988
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2. Pleiotropic resistance ~ gyr A.
30 lJd 5 fJ1J1Jd 1 u. fl. -U. fl. 2531
1~~ 2 '1111Vi'b~€J~mJWilIil1~«tJfI~'\.tbb ~~mHHb"nJb ~Uml ~ tJln~1Jd3jlh:;ffYl~1llWU1'\.tn ~1.J~€J, ~ ~
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'lJ€J.Jb~€J. m1bn'ilm1~€JtJ11'\.tn~1Jfl11'\.t Streptococcus bbYl'IJ'I1n speciesl~'\.t1l~bn'ilil ~€J WUYln '] , , m1bbtJ.JWf1'lJ€J.Jb~€J 107 bb~~ 1(jl f1~.J. i.llwu plasmid 1'\.tfll1~€J 2. S. jaecalis.
til. tJln~1Jfl11'\.t1~'\.tUl.J~1ffl1J11t1'JJlplasmid bb~~tl€J.Jn'\.t trans tIln ~1Jdi.llijU1~ffYl~1llW~m~€J~fli.ud
conjugation i.~~1tJ. 1. Streptococcus
2. tl·nhh~i1l1imvtf1TH116UtHnJI~6'1l6-:1lJl. Iim""'II'iU\\.I- 2. obligate anaerobes. " ~ q 'fl' 1 .. '" flftltl~'i 1U\~vt}l'\l6-:1lJl tIln~1J uoroqumo one 6jJ'.J1J nor 0- 3. Ureaplasma urealyticum.
xacin, pefloxacin, ofloxacin, enoxacin bb~~ ciprofloxacin U1:;ffYl~1llW~fl Mycobacterium bb~~ Chlamydia
dJ'\.tn~1J 6-fluoro-7-piperazino-4-quinolone. tJ'lnl,t~'1JUIii ~u,nutIlLb~~:;Wf1. (1iI111.J~ 1)
Yll.J1.h~ffYl~11lW~fl b~fl bb ~~ bllff'll1l ~'\.tf!lff 1iI1 b"'\.tn11tlln ~1Jfl11'\.t- brimU1tJUbYitJUU1:; ffYl~ 1llW'lJfl.JtJ11u,n ~1J fluoroqui, h'\.tbrhe1'u,3jm'il nalidixic dJU,tJl~U,bbUU. nolone l'iltJ1ifll MIC90 WU11 ciprofloxacin ijU1~ffYl~1llW
if7I1m::iinfffl1'fW!iU#a'llfNlJl £Jln~1J fluoroquinolone ff.J~ff'il. ff1U, norfloxacin, ofloxacin bb~~ pefloxicin 3j ~ ,
ij1.h:;ffYl~ 11lW~1Jln~m~fl1u,n~1J U1~ffYl~1llw1n~b~tJ.Jnu, bb~:; enoxacin ijU1~ffYl~1llW~€JtJn11, ~ ..
1. Enterobacteriaceae tJlIil1flU,. ./ 0>" V -r. 0;( ,
if'iIJflfIlifJJ1JWfJ7'lJ1iIn'llfJt/lJf17ifm tJln ~1J fluoroqui2. Enteric pathogen . , , ~ .., 1 nolone b{Ju,tIl~'IJ1vmi.~Yll.JUln. 3jtJl 2 Wf11'\.tn~1J~ijm1~11Vi'3. b'll€JYl1.JbbYl.Jbbm1J~Uparaco on ,
4. b~flYl1.JLbrl.JLbm1J~'IJ non-fermentative 111J~.J dJU,LbU'lJU'ilb'JJ1'1?)~fl'ilb~€J'il~1tJ ~fl pefloxacin bb~~ ciprofloxa
P. aeruginosa. cin. 1U,fll1 U1v\11Yll.JUlntJln ~1Jd1l:; t1n'il'iloJi1Ji.~ b111Jl nn11 I 1 \J \l I
5. Neisseria species 90 'lJfl.J'lJ'\.tl'ilYiu1V\111l~t1n'il'iloJi1J1lltJ1fltJ~:; 1u,n~1i.llbnu, 1 'il'111J.J. ~ ~
6. H. injluenzae. 1:;WfU'lJ€J.JtIl1 U,b~flm~ ~'il ~.Jbrifl'IJ1V\11V\ ~.Jmm1 til ciproflo
~l'iH~ 1 l.h~a'YInmW'Iltl-:lUl fluoroquinolone I?itl~~~W (MICso/MIC9o)
Organism Norfloxacin Pefloxacin Ofloxacin Ciprofloxacin Enoxacin
S. aureus 0.8/6.3 0.25/0.5 0.4/0.4 0.5/1 0.8/3.1 S. epidermidis 1.6/3.1 0.5/0.5 0.4/0.8 0.25/0.25 1.6/1.3 S. pyogenes 1.6/6.3 1.6/3.1 0.5/2.0 6.3/12 S. faecalis 0.8/12 0.8/1.6 1/2 12/12 S. viridans 4.0/16 2/2 1/2 16/32 S. pneumoniae 2.0/4.0 2/2 0.5/1 8/16 N. meningitidis < .12/< .12 N. gonorrhoeae 0.03/0.06 .02/.06 .01/.01 .12/.25 H. in[luenzae 0.02/0.02 0.03/.06 .4/1.6 < .02/.02 .05/.05 E. coli 0.06/0.12 0.13/.25 .05/.2 .02/.03 .1/.4 K. pneumoniae 0.2/1.6 0.2/2 .1/.2 < .12/< .12 .4/3.1 A. hydrophila < 0.02/0.03 < .1/<.1 < .01/.01 .01/.02 Salmonella .03/.06 .12/1 .13/.5 .03/.03 .1/.2 Shigella .03/.03 .06/.06 < .1/<.1 .02/.02 .1/.2 E. cloacae .1/.4 .06/1 <.12/.12 .2/.4 P. vulgan's .1/.4 .5/2 .06/.13 < .12/< .12 .4/.16 P. aeruginosa .8/3.1 1/2 .8/3.1 .25/ .5 1/2 Peptococcus 4/8 2/4 .25/2.0 4/8 B. fragilis 64/128 8/16 1.6/6.3 .5/2 25/50 C tracomatis 16/16 1/4 1/1 8/16 U. urealyticum 16/32 4/8 16/32 32/64
J Infect Dis Antimicrob Agents Vol. 5 No.1 Jan. - Mar. 1988 31
<i ffo ,d • \lIUHfl2 If) 'If"Cl'Ufllff\?l'j'lHl~Ulf)~1J fluoroqumolone
Drug Dose Route Cmax Blister fluid (% serum) AVC (ug. h/ml) Excretion (% urine) 'lli (hr)
Norflox 400 Oral 1.5 67 5.6 28 3.4 Peflox 400 Oral 3.8 46 54 10
400 l.V. 4.2 54 11 11 Oflox 600 Oral 11 47 58 7 Cipro 500 Oral 2-3 61 10 -19 3.41 3-5
100 Oral 0.5 2 4.1 100 l.V. 2.1 28 2.8 76 4
Enox 600 Oral 3.7 81 29 67 6.2
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Vol. 5 No.1 Jan. - Mar. 1988 33
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Ciprofloxacin 0, LV. * 6 Good 30 G.F., 30 - 75 3-5 -:
Coumermycin 0 5 High
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11~"iJ:; n ~ll ~.Jm1 IU1£J UI l1£JUU1:; fl 'Yl ~ 111 "W'lJB .J£J11 Vi ~l'a~B I-nB mycin iiu ii11£J.J1Ul1BHHffu MRSA i,~ 11~~t'lbbU1U11UlJ1n
MRSA. 'il1lJJl3Jfl1fl'il1. £J1 vancomycin 11JU£J1~m1ulltiuBU11i,~~t'l~ ~
1. l.h:all1fimV'l~tlI~{lMRSA IrlBH1:;~U MICgo dJU lum11n~1hflluflull~iJ11fl1bb"W.J3J1n bbt'l:;e1'il11m1V11£J"iJ1nhfl
Ifl~B.J~~flU coumermycin iiU1:;fl'Yl~Jl1"W~~fl~~m~B, MRSA, fiti.Ji,ll~.J"iJUI1JU~"WBh. m~ui l'liu coumermycin, teicoplanin
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1:;W11.J Cmax nu MICgo "iJ:;"WU11 coumermycin 11JU£J1~~ quinolone llt'l:; imipenem fitiH:;l~~t'l~I'liuffu. Bcl1.Ji,1fi'il13J
~~~~m'liuI~£JlnU('il111.J~ 3). £J1'Yln ~l ii11fl1 bb"W .J3J1 nil t'l:;~ t'ln1d1n ~1 i,1li,~fl3JUd mlri1~ fl1~, ~
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a"::s Q..o a A a o::!tIU~£JUIIUt'l.Jlu11.Jm£J. 1:;£J:;~ .Jm'il£J1l~.Jbb~ 4-24 off113J.J. ('il111.J m1lJlfl£JV11£J'lJU3J1n. "iJ:;'ilB.J3Jm1fl~3J1'il1m1'Yl"iJ:;t'l~11fl1£J1Vi1B
~ 4). H£J1'Yl~11 'YlU~"WB"iJ:;i,~~ t'llum nlL'liud.
3. ~lI'\l{l>1Ul lu1:;£J:;~Ui vancomycin iimJ~m1m1 , . In~"W~mfl.J II~lm:;£J:;Vi ~.J"Wull'~~'lJB .J£J11n~"iJ1n fl11i,1lU1fl'Yl~, ~u:;uUBcl
~
bbt'l:;lutf"iJ"iJDu~~~l.J i ii'ltB£J3J1n~ .Jiil~£J.J~U, n~3J ~, ,
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1. uih1 ll~11nii. ulu~;hu~f1~1Jhllj : quinolone compounds. 11Hl1~ teicoplanin ff.JB~lm:;Vil1.J'Yl~t'lB.Jff.Ji,1l"Wu~~3J1nlufl'ill'Yl~- 1~f1&1moifllllll~ullli'lU~ll;;Yl 2527; 1:233-8.
t'lB.J"WU11£J1dii~~~Bi,'il. £11 coumermycin ff.Ji,lli,~~n'it l3J1H 2. ll'~ii YH!f1lJ1fl&111'il, 'uihl lltl11nii. tl111Jl1~IlWillrlllhf1Ill11Ulciproflo
~acin lUl11111I'lI';l'Illll~. 11~ll'nhf1&1I'1I~1ll11l~Ullli'lU~1l;;Yl2529; 3:167-9. 1UflU~.Jff.Ji,1lm1 u~.J~~'lJB.J£J1.
3. ~~ii Ylqf1lJ'lfl&111'il, uihl li'tnlnii, tllJUl 1~~I\!~~.·f1111Jl1~Il~llUf1'ih~u 4. tl111...rl1Hfliliitl ii vancomycin 1~£J.J~11~£Jl~iJm1· rllll~f1Ill11Ul.llU~lliYl~UlUlmL11~ ll'l~ hf1&1I'1I,jllllll~Ullli'lU~ll;;Yl 2530;
4:157-61$ln~lBcl1.Jn11.J'lJl1.J "Wul1B'ild1m1V11£J"iJ1nm1H£J1d\1\B1B£J t'l:; .. .. , q'; ... 4. 111J1 11ll1~~tl1J. Imipenem. lnll'l~ 1~f11'11'111fllllll~Ulf\1U~1l'lfYl 2530; 4:
60-87. IrlBH1l3JffU rifampicin e1'il11m1V11£J"iJ:;I1Ju1B£Jt'l:; 133-50.
35 J Infect Dis Antimicrob Agents
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