title: In vitro evaluations of aminopenicillin/beta-lactamase inhibitor combinations.
abstract: Sulbactam/ampicillin (Unasyn) possesses the antimicrobial activity of each drug plus the synergistic action and qualities of sulbactam used as a beta-lactamase inhibitor. The combination has a spectrum of activity against many Enterobacteriaceae, Haemophilus species, Branhamella catarrhalis, pathogenic Neisseria species, Acinetobacter anitratus, some pseudomonads, nearly all anaerobes (including Bacteroides), Staphylococcus species, streptococci, and the enterococci. Sulbactam/ampicillin was found to be bactericidal, and its minimum inhibitory concentrations (MICs) affected only by high inoculum concentrations (greater than 10(6) CFU/ml). Fixed ratio in vitro susceptibility tests appear to be preferred, since they best approximate clinical formulations and drug pharmacokinetics. The ratio of 1:1 has been studied, but other ratios such as 1:2 (sulbactam/ampicillin) should be evaluated to promote greater test accuracy. Separate interpretive criteria for most Gram-negative bacteria, Haemophilus, and staphylococci appear unnecessary for some tests.
authors.affiliation: Clinical Microbiology Institute, Tualatin, Oregon.
authors.forename: R N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D002463:Cell Membrane Permeability / Q000187:drug effects; D002969:Clavulanic Acids / Q000494:pharmacology; D004347:Drug Interactions; D004755:Enterobacteriaceae / Q000187:drug effects; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006868:Hydrolysis; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology*; D013407:Sulbactam / Q000494:pharmacology; D065093:beta-Lactamase Inhibitors
chemical_list: D002969:Clavulanic Acids; D010406:Penicillins; D065093:beta-Lactamase Inhibitors; D000667:Ampicillin; D000658:Amoxicillin; D010400:Penicillin G; D013407:Sulbactam