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題 名 | Susceptibility Testing and Clinical Effect of Fusidic Acid in Oxacillin-Resistant Staphylococcus Aureus Infections=Fusidic acid對Oxacillin抗藥性金黃色葡萄球菌感染之感受性及臨床療效 |
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作 者 | 劉昌邦; 李聰明; 蘇世強; 李怡增; | 書刊名 | 微免與感染雜誌 |
卷 期 | 32:3 1999.09[民88.09] |
頁 次 | 頁194-198 |
分類號 | 414.83 |
關鍵詞 | Oxacillin抗藥性金黃色葡萄球菌; Oxacillin-resistant staphylococcus aureus; Fusidic acid; |
語 文 | 英文(English) |
中文摘要 | Oxacillin抗藥性金黃色葡萄球菌(Oxacillin-resistant Staphylococcus aureus, ORSA )所造成的感染已有日益增強的趨勢。 傳統治療 ORSA 感染時, glycopeptide 仍是目前優先的選擇。 但是 glycopeptide 類的抗生素,如 vancomycin 或 teicoplanin,皆以針劑之注射來對抗 ORSA 之感染。 若病患對 glycopeptide 有過敏反應 ,則須使用其它類的抗生素。因此 fusidic acid 對 ORSA 感染的感受性及臨床療效,將加 以詳細評估及研究。口服劑之 fusidic acid 可以被腸胃道良好的吸收,並維持高而持久的 血中濃度。 fusidic acid 亦有針劑, 但本評估報告乃針對口服製劑予以評估、研究。 從 1997 年至 1998 年, 共有 106 株的 ORSA 菌株列入測試,fusidic acid 對 ORSA 菌株的 MIC 值由 0.06 μ g ╱ mL 至 4 μ g ╱ mL。當 MIC 值的臨界值設定在 2 μ g ╱ mL。 僅有 1 株 ORSA 菌株顯示出抗藥性,佔 0.9 %。口服的 fusidic acid 用於治療 ORSA 的 輕度感染,皆顯示出滿意的臨床療效。而在 ORSA 之嚴重感染,則在 glycopeptide 針劑治 療後,口服的 fusidic acid 用於後續之治療, 在 20 例嚴重 ORSA 感染的病患,有 3 例 顯示出復發的情形。關於 ORSA 傷口感染或 ORSA 骨髓炎之復發情形,亦和手術清創有關或 和病患之抵抗力有關。 ORSA 復發也顯示出此種菌株之難纏,一旦感染,有時非常難以完全 清除或治療。 |
英文摘要 | One hundred and six oxacillin-resistant Staphylococcus aureus (ORSA) isolates collected from various clinical specimens at Mackay Memorial Hospital during the period from 1997 to 1998 were tested. The MICs of fusidic acid against ORSA isolates were in the range of 0.06 μ g/mL to 4 μ g/mL. There was only one ORSA isolate (0.9%) resistant to fusidic acid in this study. Twenty-four patients with ORSA infection were enrolled into the study between July 1997 to June 1998. Four patients without the evidence of sepsis received oral fusidic acid only. The other 20 patients with sepsis received intravenous glycopeptide first, and then the oral fusidic acid for 7 to 10 days. Oral fusidic acid was used for mild ORSA infection and achieved satisfactory clinical outcome. In severe ORSA infection, it was found that sequential therapy with fusidic acid had relapsed in three patients. We concluded that oral fusidic acid achieved a satisfactory outcome in our patients with mild ORSA infection. In such cases, fusidic acid may provide an effective alternative treatment of choice. The rare side effect of granulocytopenia and jaundice was noted in our case series. The side effect may be not so rare as previously thought, if it had been carefully looked for. |
本系統中英文摘要資訊取自各篇刊載內容。