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首页> 外文期刊>Antimicrobial agents and chemotherapy. >Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia
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Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia

机译：头孢曲松，头孢噻肟，十二胞环素，环丙沙星和vibrio wulnfificus foodsore败血症的组合治疗的疗效

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Foodborne Vibrio vulnificus infections are associated with higher rates of sepsis and mortality than wound infections; however, antibiotic efficacy studies have not been performed in foodborne infection models. The efficacies of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy were assessed in V. vulnificus intestinal infection in mice in order to model foodborne infections. In accordance with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin in vitro; combination therapy significantly decreased bacterial growth, by >= 2 log(10) units, from that with antibiotic monotherapy (P < 0.01). In vivo, survival rates in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than those in the control group (0%) (P < 0.0001). Survival was significantly higher with ceftriaxone-doxycycline (91%) or ceftriaxoneciprofloxacin (100%) therapy than with ceftriaxone (50%) (P <= 0.05). Survival with cefepime-doxycycline (96%) or cefepime-ciprofloxacin (90%) therapy was significantly higher than that with cefepime alone (20%) (P < 0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for foodborne V. vulnificus septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and V. vulnificus pending a microbiological diagnosis. Once a diagnosis of foodborne V. vulnificus septicemia is established, treatment can safely transition to ceftriaxone in combination with doxycycline or ciprofloxacin.
机译：Fouthborne Vibrio Wulnfificus感染与败血症和死亡率的较高率相关，而不是伤口感染;然而，在食源性感染模型中尚未进行抗生素疗效研究。在小鼠的V.Vulnfificus肠道感染中评估了头孢曲松，头孢噻肟，十氧环素，环丙沙星和联合治疗的效果，以便模拟食源性感染。按照对头孢噻肟的先前研究，头孢噻肟在体外与强霉素和环丙沙星进行协同作用;组合治疗显着降低了细菌生长，通过> = 2种Log（10）单位，从中具有抗生素单疗法（P <0.01）。体内，头孢曲松（50％），十二酸盐（79％）和环丙沙星（80％）组中的存活率明显高于对照组（0％）（P <0.0001）。生存率显着高于头孢菌 - 辛杂环素（91％）或头孢噻二氯氧氟沙星（100％）疗法而不是Ceftriaxone（50％）（P <= 0.05）。与头孢噻肟 - 十氧环（96％）或头孢噻肟 - 环丙沙星（90％）治疗的存活率明显高于单独的头孢费（20％）（P <0.001）。组合治疗组之间存活率没有差异。因此，我们得出结论，联合治疗是食物载体败血症败血症的最有效的治疗方法。在近期摄入的腐败患者中，最近的生海鲜，应开始与十氧环或环丙沙星组合的头脑，以覆盖抗性革兰氏阴性生物和vulnfificus等待微生物诊断。一旦建立了食品脱血症败血症的诊断，可以将治疗安全地与十氧环素或环丙沙星联合转变为头孢曲松。

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