Piperacillin tazobactam compared with co-amoxiclav, ampicillin plus sulbactam and timentin against beta-lactamase-producing clinical isolates of Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca.
A total of 266 enterobacterial isolates (Escherichia coli = 190, Klebsiella pneumoniae = 49, K. oxytoca = 27) were tested for susceptibility (Bauer-Kirby agar disk diffusion test and agar dilution procedure) to ampicillin, ampicillin in 10 micrograms/ml of sulbactam, amoxicillin in 4 micrograms/ml of clavulanic acid, piperacillin, piperacillin plus tazobactam (8:1 ratio), ticarcillin and timentin (ticarcillin in 4 micrograms/ml of clavulanic acid). Discrepant results between the two methods of susceptibility testing were categorized as follows: category I = very major [minimal inhibitory concentration (MIC) = resistant, disk diffusion = susceptible] category II = major (MIC = susceptible, disk diffusion = resistant), category III = minor (MIC = intermediate susceptibility, disk diffusion = susceptible), category IV = slight (MIC = resistant, disk diffusion = intermediate), category V = minimal (MIC = susceptible, disk diffusion = intermediate) and category VI = negligible (MIC = intermediate, disk diffusion = resistant). The antibiotics, or combinations with beta-lactamase inhibitors, yielded the following discrepant results: ampicillin (II = 2, V = 1 and VI = 3), co-amoxiclav (I = 5, III = 25, IV = 1 and V = 3), ampicillin plus sulbactam (I = 5, II = 3, III = 1, V = 19 and VI = 1), piperacillin (II = 15, III = 1, V = 15 and VI = 85), piperacillin plus tazobactam (III = 16, IV = 2, V = 1 and VI = 5) and timentin (I = 2, III = 48 and IV = 1).(ABSTRACT TRUNCATED AT 250 WORDS)
Institut für Medizinische Mikrobiologie und Hygiene, Universität des Saarlandes, Homburg/Saar, Germany.
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Leonhard
D000658:Amoxicillin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002969:Clavulanic Acids / Q000494:pharmacology; D004791:Enzyme Inhibitors / Q000494:pharmacology; D004926:Escherichia coli / Q000187:drug effects*; D007711:Klebsiella pneumoniae / Q000187:drug effects*; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D010878:Piperacillin / Q000494:pharmacology*; D013407:Sulbactam / Q000494:pharmacology; D000078142:Tazobactam; D013982:Ticarcillin / Q000494:pharmacology; D001618:beta-Lactamases / Q000187:drug effects
D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D004791:Enzyme Inhibitors; D000667:Ampicillin; D000658:Amoxicillin; C043215:ticarcillin-clavulanic acid; D010397:Penicillanic Acid; D001618:beta-Lactamases; D013982:Ticarcillin; D013407:Sulbactam; D000078142:Tazobactam; D010878:Piperacillin