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임상분리세균의 각 세대별 cephalosporin에 대한 감수성
박성섭,김의종,김상인 대한화학요법학회 1986 대한화학요법학회지 Vol.4 No.1
A new generation of cephalosporins has been developed. The new drugs are more resistant to inactivation by beta-lactamase and have broader antibacterial spectra against Gram-negative bacteria. Especially the new cephalosporins offer significant advances for the treatment of infections caused by some multiresistant Gram-negative bacilli. But in vitro data from several reports can be conflicting due to geographic differences in susceptibility pattern and because subtle differences in techniques can yield sizable differences in susceptibility results. Authors studied the antibacterial activities of 6 cephalosporins, including cephalothin, cefoxitin, cefuroxime, cefoperazone and ceftizoxime against clinical bacterial strains of Seoul National University Hospital by Kirby-Bauer disk diffusion test. The results are as follows; 1. Enterobacteriaceae could be divided to 3 groups based on the susceptibility patterns to three generation cephalosporins. Group Ⅰ consisted of E. coli, Klebsiella and P. mirabilis and group Ⅱ consisted of M. morganii and Entrobacter. Group Ⅲ consisted of C. freundii and S. marcescens, but C. freundii needed more studies. 2. Cephalothin, the representative of the first generation cephalosporin, was highly active against methicillin-sensitive S. aureus and Enterobacteriaceae group Ⅰ. 3. The second generation cephalosporins showed broader antibacterial spectrum than cephalothin. Cefoxitin was more potent agent against S. marcescens and cefuroxime was more potent agent against E. cloacae. 4. The third generation cephalosporins showed much more broader antibacterial spectrum and different activities by each drug. Cefotaxime was generally active against all bacteria tested except glucose-nonfermentative Gram-negative bacilli and S. marcescens. Cefoperazone was the most active agent tested against P. aeruginosa. Ceftizoxime was the most potent agent tested against E. cloacae, S. marcescens and some of A. calcoaceticus. It is concluded that selection of antibiotics and based on the results of the identification and antimicrobial susceptibility test of the isolates and data of the susceptibility patterns of the hospital strains to the new drugs. Careful use of the new antimicrobial agents will benefit patient care and cost-effective therapy and reduce the emergence of resistant strains to the new drugs.
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