title: Comparative evaluation of orally active antibiotics against community-acquired pathogens: a multi-center study in five Mediterranean countries.
abstract: In 5 Mediterranean countries 7902 pathogens, all isolated in 1992 and 1993 from community-acquired infections, were studied for susceptibility to the following orally active antibiotics: penicillin G, ampicillin, ampicillin + sulbactam, amoxycillin + clavulanic acid (both 2:1 ratio), cefalexin, cefaclor, cefuroxime, cefetamet, doxycycline and erythromycin. Ten centers in Italy, 4 centers in Greece, 3 centers in Spain, and 1 center in Lebanon and Saudi Arabia contributed to this study; all centers used performed standardized microtiter panels (Sceptor, BBL, Heidelberg, FRG). The most frequently isolated pathogens were Escherichia coli (n = 1267), Proteus mirabilis (n = 843), Klebsiella pneumoniae (n = 771), enteric Salmonella spp. (n = 629), Enterobacter cloacae (n = 486), Citrobacter freundii (n = 383), Streptococcus agalactiae (n = 346), Haemophilus influenzae (n = 298), Streptococcus pyogenes (n = 294), Streptococcus pneumoniae (n = 246), Klebsiella oxytoca (n = 243), and Shigella spp. (n = 185). Statistical analysis was performed for each of the above countries and for all pooled data available. The penicillin antibiotics were the most active compounds against the gram-positive cocci, exceeding the MIC90 values 2- to 8-fold over all cephalosporins. Regarding the gram-negatives (above all Klebsiella spp.) cefetamet was by far the most active compound (MIC90 = 1 mg/l). Regarding the percentage of resistant isolates, there were no striking discrepancies between the centers and countries involved in this study. There was, however, complete cross-resistance in penicillin-resistant S. pneumoniae isolates (MIC90 = 2 mg/l). By far the majority of the penicillin-resistant pneumococci showed additional resistance to doxycycline and erythromycin.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Dept. of Clinical Chemistry and Immunology, Buergerhospital Stuttgart, FRG.
authors.forename: W
authors.initials: W
authors.lastname: Cullmann
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology*; D005069:Evaluation Studies as Topic; D006801:Humans; D008522:Mediterranean Sea; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents