|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|5666951||1591738||2017||3 صفحه PDF||سفارش دهید||دانلود کنید|
- Macrolide-resistant Mycoplasma pneumoniae (MRMP) infections are increasing worldwide.
- Treatment of MRMP poses particular problems in paediatrics owing to the side effects of alternative agents.
- In culture, minocycline, doxycycline and tosufloxacin showed similar time-kill kinetics.
- Post-antibiotic effects were clearly better with minocycline and doxycycline.
- Pharmacokinetic parameters, not only MIC, should be considered in clinical choices.
Macrolide-resistant Mycoplasma pneumoniae (MRMP) has emerged and is increasing worldwide. In a 2011 outbreak of MRMP infections in Japan, symptoms failed to improve in many patients who initially received macrolides; the therapeutic agent was then changed to minocycline (MIN), doxycycline (DOX) or tosufloxacin (TFX). In this study, the bactericidal effects of these three agents against MRMP were evaluated. Time-kill kinetics against MRMP and macrolide-susceptible M. pneumoniae (MSMP) were determined for 5 days at concentrations corresponding to the respective minimum inhibitory concentration (MIC) and 2âÃâMIC, i.e. 1âÂµg/mL and 2âÂµg/mL for MIN, 0.5âÂµg/mL and 1âÂµg/mL for DOX, and 0.5âÂµg/mL and 1âÂµg/mL for TFX. The post-antibiotic effects (PAE) of these agents in culture against MRMP were also examined based on their pharmacokinetic parameters in children. Following exposure of MRMP and MSMP to up to twice the respective MICs of MIN, DOX and TFX, viable cells initially numbering 106âCFU/mL had decreased similarly to 103âCFU/mL after 4 days. Clarithromycin and azithromycin showed good bactericidal action against MSMP but not against MRMP. PAEs against MRMP appeared superior with MIN and DOX compared with TFX. In infection with M. pneumoniae having a generation time exceeding 6âh, a therapeutic agent must be selected in consideration of pharmacokinetic parameters, not MICs alone.
Journal: International Journal of Antimicrobial Agents - Volume 50, Issue 2, August 2017, Pages 255-257