Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria.
The in vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checkerboard agar dilution technique. Cefepime showed excellent in-vitro activity against Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Proteus vulgaris (MIC90 0.03-0.125 mg/l) and good to moderate activity against Acinetobacter anitratus, Pseudomonas aeruginosa and Pseudomonas cepacia (MIC90 4-16 mg/l). SCE-2787 had an excellent activity against Citrobacter spp. (MIC90 0.125 mg/l) and a very good activity against A. anitratus, P. aeruginosa and P. vulgaris (MIC90 1-2 mg/l). Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14-28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.
Hübner
J
J
Klinikhygiene, Universitätsklinikum, Freiburg, Germany.
Hartung
D
D
Kropec
A
A
Daschner
F D
FD
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000494:pharmacology; D005839:Gentamicins / Q000494:pharmacology; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D014031:Tobramycin / Q000494:pharmacology; D000097586:Cefozopran
D000900:Anti-Bacterial Agents; D000077723:Cefepime; D002511:Cephalosporins; D005839:Gentamicins; D014031:Tobramycin; D000097586:Cefozopran