title: [In vitro bactericide activity of different antibiotic combinations to Streptococcus pneumoniae resistant to penicillin and cefotaxime].
abstract: BACKGROUND
  To determinate the bactericidal activity of vancomycin, rifampicin, cefotaxime, ceftriaxone and their double and triple combinations against penicillin and third generation cephalosporin-resistant. Streptococcus pneumoniae strain.
  
  
  METHODS
  A study of the bactericidal activity of antibiotics alone and in combination was performed by killing-curves with fixed concentration of 2 micrograms/ml, equivalent to 1 < MIC for cefotaxime and ceftriaxone, to 8 x MIC for vancomycin and to 32 < MIC for rifampin.
  
  
  RESULTS
  Vancomycin was the only antibiotic with bactericidal effect at 6 hours. Cefotaxime had bactericidal effect at 12 hours. Rifampin had no bactericidal effect. The association of vancomycin plus third generation cephalosporins (cefotaxime and ceftriaxone) showed indifferent effect. Rifampin decreased the bactericidal activity of vancomycin at 12 hours, when both were studied in combination, and it demonstrated antagonistic effect in the double and triple combination in which rifampicin was included.
  
  
  CONCLUSIONS
  All associations of vancomycin plus third generation cephalosporins were bactericidal effects, but they did no show synergistic effects against penicillin- and third generation cephalosporin S. pneumoniae strain 2349. All combinations with rifampin showed decreased bactericidal activity or antagonistic effects. However, these results may be interpreted with caution because the in vivo experience of an experimental meningitis model in rabbits showed that the associations of vancomycin plus rifampin and vancomycin plus cefotaxime and rifampin were effective combinations. More in vivo and in vitro comparative studies are needed to demonstrate the reliability of in vitro results.
authors.affiliation: Servicio de Microbiologia, Hospitalet de Llobregat, Barcelona.
authors.forename: F
authors.initials: F
authors.lastname: Tubau
authors.forename: J
authors.initials: J
authors.lastname: Liñares
authors.forename: C
authors.initials: C
authors.lastname: Ardanuy
authors.forename: J
authors.initials: J
authors.lastname: Martínez-Lacasa
authors.forename: A
authors.initials: A
authors.lastname: Fernández
authors.forename: C
authors.initials: C
authors.lastname: Cabellos
authors.forename: P
authors.initials: P
authors.lastname: Fernández-Viladrich
authors.forename: R
authors.initials: R
authors.lastname: Martín
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000188:drug therapy; D008826:Microbial Sensitivity Tests; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Actividad bactericida in vitro de diferentes combinaciones de antibióticos frente a Streptococcus pneumoniae resistente a penicilina y cefotaxima.