INVITRO COMPARISON OF MEZLOCILLIN AND PIPERACILLIN PLUS TOBRAMYCIN OR GENTAMICIN VERSUS 100 GRAM-NEGATIVE NOSOCOMIAL BLOOD-STREAM ISOLATES

被引:3
作者
CABEZUDO, I
PFALLER, MA
BARRETT, M
BALE, M
WENZEL, RP
机构
[1] Veterans Administration Medical Center, the Departments of Pathology, Medicine University, Iowa City, IA
关键词
D O I
10.1016/0196-6553(90)90166-P
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
We compared the in vitro activity of mezlocillin and piperacillin, alone and in combination with tobramycin or gentamicin, against clinical isolates of gram-negative bacilli from hospitalized patients with 100 distinct episodes of nosocomial bacteremia. The minimum inhibitory concentrations (MICs) necessary to inhibit 50% and 90% of isolates showed that piperacillin was most active against Pseudomonas aeruginosa. The MIC needed to inhibit 90% of isolates also showed that mezlocillin was more active against Enterobacter cloacae. Activities of the two acylaminopenicillins were comparable against the rest of the isolates. Combining the acylaminopenicillins with either gentamicin or tobramycin decreased the MICs fourfold or more for both combinations. Synergy occurred more frequently with mezlocillin-gentamicin (12%), followed by piperacillin-tobramycin (9%), mezlocillin-tobramycin (6%), and piperacillin-gentamicin (5%). Antagonism for Enterobacteriaceae isolates was observed most frequently with the combination of piperacillin plus tobramycin (20%), followed by mezlocillin plus tobramycin (17.6%), piperacillin plus gentamicin (12.9%), and mezlocillin plus gentamicin (8.2%). There are very few differences in the activities of mezlocillin and piperacillin combined with either gentamicin or tobramycin versus nosocomial gram-negative bloodstream isolates. © 1990.
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页码:250 / 256
页数:7
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共 34 条
  • [1] Wenzel, The mortality of hospital-acquired bloodstream infections need for a new vital statistic?, International Journal of Epidemiology, 17, pp. 225-227, (1898)
  • [2] McCabe, Jackson, Gram-negative bacteremia I Etiology and ecology, Archives of Internal Medicine, 110, pp. 847-855, (1962)
  • [3] McCabe, Jackson, Gram-negative bacteremia II Clinical laboratory and therapeutic observations, Archives of Internal Medicine, 110, pp. 856-864, (1962)
  • [4] Klastersky, Cappel, Daneau, Clinical significance of in-vitro synergism between antibiotics in gram-negative infections, Antimicrobial Agents and Chemotherapy, 2, pp. 470-475, (1972)
  • [5] Anderson, Young, Hewitz, Antimicrobial synergism in the therapy of gram-negative bacteremia, Chemotherapy, 24, pp. 45-54, (1978)
  • [6] Klastersky, Zinner, Combinations of antibiotics for therapy of severe infections in cancer patients, Infection, 8, pp. 229-233, (1980)
  • [7] Klastersky, Swings, Daneau, Antimicrobial activity of the carbenicillin/gentamicin combination against gram-negative bacilli, The American Journal of the Medical Sciences, 260, pp. 373-380, (1970)
  • [8] Lau, Young, Black, Et al., Comparative efficacy and toxicity of amikacin/carbenicillin versus gentamicin/carbenicillin in leukopenic patients a randomized prospective trial, The American Journal of Medicine, 62, pp. 959-966, (1977)
  • [9] Allan, Moellering, Management of infection caused by gram-negative bacilli the role of antimicrobial combinations, Clinical Infectious Diseases, 7, pp. 559-571, (1985)
  • [10] Klasterky, Cappel, Daneau, Therapy with carbenicillin and gentamicin for patients with cancer and severe infections caused by gram-negative rods, Cancer, 31, pp. 331-380, (1973)