title: [A fosfomycin-gentamicin combination in the treatment of experimental endocarditis caused by Klebsiella pneumoniae producing type TEM-3 beta-lactamase].
abstract: The authors studied the activity of fosfomycin (FOS) and/or gentamicin (GEN) against a Klebsiella pneumoniae strain resistant to all beta-lactams--except cephamycins and imipenem--by production of a plasmid mediated extended broad-spectrum beta-lactamase-TEM-3, to all aminoglycosides--except gentamicin--by production of a plasmid mediated 6' aminoglycoside acetyltransferase IV, to sulfonamides and to tetracyclines. In vitro, the combination FOS (MIC = MBC = 32 mg/l) + GEN (MIC = MBC = 2) appeared indifferent (FIC = 0.75; FBC = 1). In vivo, on experimental endocarditis in rabbits, FOS alone was ineffective, GEN alone was active but only at high dose regimen, FOS - GEN combination was active as compared with controls. Fosfomycin - gentamicin combination may be an alternative in the therapy of severe infections due to multiresistant Enterobacteriacae.
authors.affiliation: INSERM U.13, Hôpital Claude-Bernard, Service de Médecine Interne, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Caron
authors.forename: A
authors.initials: A
authors.lastname: Bure
authors.forename: B
authors.initials: B
authors.lastname: Pangon
authors.forename: J P
authors.initials: JP
authors.lastname: Bedos
authors.forename: J M
authors.initials: JM
authors.lastname: Vallois
authors.forename: C
authors.initials: C
authors.lastname: Gaudebout
authors.forename: C
authors.initials: C
authors.lastname: Carbon
mesh_terms: D000818:Animals; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000494:pharmacology / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D005260:Female; D005578:Fosfomycin / Q000494:pharmacology / Q000627:therapeutic use*; D005839:Gentamicins / Q000494:pharmacology / Q000627:therapeutic use*; D066298:In Vitro Techniques; D007710:Klebsiella Infections / Q000188:drug therapy*; D007711:Klebsiella pneumoniae / Q000201:enzymology*; D011817:Rabbits; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D005839:Gentamicins; D005578:Fosfomycin; D001618:beta-Lactamases
vernacular_title: Association fosfomycine-gentamicine dans le traitement d'une endocardite expérimentale à Klebsiella pneumoniae produisant une beta-lactamase de type TEM-3.