title: Clinical efficacy of a synergistic combination of cefotaxime and amikacin against multiresistant Pseudomonas and Serratia infections.
abstract: The synergistic activity of cefotaxime and amikacin against 21 highly resistant Pseudomonas aeruginosa and Serratia marcescens isolates was evaluated in-vitro by the checkerboard tube dilution method and in-vivo in five patients with serious infections caused by these organisms. All isolates were resistant to gentamicin, tobramycin, amikacin, and cefotaxime. Synergy was observed in 90% of isolates and occurred when the MIC of amikacin was less than 256 mg/l and of cefotaxime less than 1024 mg/l. A clinical response occurred in 100% and bacteriological cure in 80% of patients. Our results demonstrate a high degree of synergism between amikacin and cefotaxime in-vitro and clinical efficacy in the treatment of infections due to multiply-resistant Pseudomonas and Serratia species.
mesh_terms: D000368:Aged; D000583:Amikacin / Q000494:pharmacology / Q000627:therapeutic use*; D000617:Aminoglycosides / Q000627:therapeutic use; D002439:Cefotaxime / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007612:Kanamycin / Q000031:analogs & derivatives*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology; D012706:Serratia marcescens / Q000187:drug effects
chemical_list: D000617:Aminoglycosides; D007612:Kanamycin; D000583:Amikacin; D002439:Cefotaxime