title: Synergistic killing of vancomycin-resistant enterococci of classes A, B, and C by combinations of vancomycin, penicillin, and gentamicin.
abstract: Using both high and low inocula for time-kill curves, we examined the antibiotic killing of clinical isolates of glycopeptide-resistant enterococci (Enterococcus faecium, E. faecalis, and E. gallinarum) belonging to phenotypic resistance classes A, B, and C. None were resistant to high levels (greater than 500 mg/liter) of gentamicin. Vancomycin-penicillin-gentamicin resulted in 2 or more logs of killing above that of the most effective two-antibiotic combination for all strains except two of three E. gallinarum (VanC) strains and a constitutive mutant of a VanB strain. This strategy may be useful clinically.
authors.affiliation: Infectious Diseases Section, Department of Veterans Affairs Medical Center, Cleveland, Ohio.
authors.forename: D M
authors.initials: DM
authors.lastname: Shlaes
authors.forename: L
authors.initials: L
authors.lastname: Etter
authors.forename: L
authors.initials: L
authors.lastname: Gutmann
mesh_terms: D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000494:pharmacology; D005839:Gentamicins / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology*; D013291:Streptococcus / Q000187:drug effects*; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D005839:Gentamicins; D010406:Penicillins; D014640:Vancomycin