Pliego-Castañeda A, Yánez-Viguri JA, López-Valle T

Language: Spanish
References: 25
Page: 465-470
PDF size: 101.67 Kb.

ABSTRACT

Introduction: In vitro antibiotic combination testing would guide therapy selection in patients severely infected by multi-drug resistant Pseudomonas.
Objectives: In vitro, a two-antibiotic combination susceptibile against multi-drug resistant Pseudomonas isolated at the Laboratorio Clínico of the Hospital de Oncología, Centro Médico Nacional Siglo XXI in Mexico City were analyzed to determine which antibiotic combination showed the best bactericidal activity.
Material and methods: During 10 months, 30 multi-drug resistant Pseudomonas strains were tested. An automated method was used, including a diluting solution with a well-known concentration of a second antibiotic. Quality controls recommended by the NCCLS were used: Pseudomonas aeruginosa ATCC 27853; Escherichia coli ATCC25922; and Escherichia coli ATCC 35218. Combinations were betalactamics-aminoglycosides; carbapenems-amikacin; fluoroquinolones-cefepime and ciprofloxacin-ampicillin.
Results: Ampicillin-ciprofloxacin combination was bactericidal against 100% of the isolates. Cefazolin, cefixime and ticarcillin with amikacin: ›50%; aztreonam, cefoxitin, cefuroxime, cefotaxime, ceftazidime and piperacillin with amikacin: 50-60%; cefepime with gentamicin: 76%; cefepime with amikacin: 86%; imipenem and meropenem with amikacin: 70% and 76%; cefepime with ciprofloxacin: 83%; cefepime with levofloxacin: 73%.
Conclusions: In vitro antibiotic combination susceptibilities against multi-drug resistant bacteria would be the only way to guide clinicians to select the best therapy in severe infections. We found that the ampicillin-ciprofloxacin combination showed the best in vitro effect against multi-drug resistant Pseudomonas.

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