关键词: 利福平, 耐甲氧西林金黄色葡萄球菌, 哺乳期, 乳腺脓肿, 左氧氟沙星

Abstract: Objective To value the effective and safety therapy of community breast abscess by MRSA infection that treated with rifampin plus levofloxacin and the therapy of its mechanism. Methods From January 2010 to December 2018,there were 86 breast abscess by MRSA infected. All the cases were divided into levofloxacin + rifampicin treatment group and vancomycin treatment group. The cure rate, the clearance rate of MRSA, treatment time, antimicrobial treatment cost and the adverse reactions of antibiotics were observed. The evofloxacin agar plate,rifampicinagar plate, levofloxacin combined with rifampicin agar plate were made respectively. The concentration of all the agar plates changed gradiently. And the MIC, MPV and MSW of each agar plate was cheeked. Results The cure rate of levofloxacin + rifampicin treatment group and vancomycin were 93% and 97% respectively（P>0.05）. MRSA clearance rate were 100% of two group. The treatment time of levofloxacin + rifampicin treatment group and vancomycin were 8.8 and 9.1 days respectively（P>0.05）. Antimicrobial cost of levofloxacin + rifampicin treatment group and vancomycin were 700 yuan and 2000 yuan respectively（P<0.05）. The incidence of adverse drug reactions rate of evofloxacin + rifampicin was 11.4%; incidence of adverse drug reactions rate of vancomycin was 12.2% （P>0.05）. Bacteria in vitro experiments show that levofloxacin and rifampicin can shrink their MIC, MSW, and MPV. The rifampicin was more obvious. Conclusion The patients who got breast abscess that infected by MRSA in community, treated with Rifampin combined with Levofloxacin therapy could get high cure rate,low cost,less side effects.It could be used as one of the important treatment of clinicians. Rifampin combined with Levofloxacin can reduce the MPV and narrow its MSW to treat MRSA.And it may be the important mechanism of the rifampin combined with Levofloxacin to treat MRSA.

Key words: lactationperiod, rifampin, Methicillin-resistant Staphylococcus aureus, breast abscess, Levofloxacin