An evaluation of the bactericidal activity of ampicillin/sulbactam, piperacillin/tazobactam, imipenem or nafcillin alone and in combination with vancomycin against methicillin-resistant Staphylococcus aureus (MRSA) in time-kill curves with infected fibrin clots.
The activity of piperacillin/tazobactam, ampicillin/sulbactam, imipenem and nafcillin alone and in combination with vancomycin was compared with vancomycin monotherapy against MRSA in test-tube time-kill studies and in infected fibrin clots. Bactericidal activity was achieved with all regimens except nafcillin monotherapy in test tubes but only with imipenem/vancomycin and nafcillin/vancomycin in fibrin clots infected with heterogeneous strains. No regimen was effective against the homogeneous strain. These agents may have potential as alternatives to vancomycin in selected infections.
Palmer
S M
SM
The Anti-infective Research Laboratory, Detroit Receiving Hospital, Wayne State University, MI 48201, USA.
Rybak
M J
MJ
D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000494:pharmacology; D005337:Fibrin; D015378:Imipenem / Q000494:pharmacology; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009254:Nafcillin / Q000494:pharmacology; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology*; D010878:Piperacillin / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013407:Sulbactam / Q000494:pharmacology*; D000078142:Tazobactam; D014640:Vancomycin / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D009254:Nafcillin; D014640:Vancomycin; D015378:Imipenem; D000667:Ampicillin; D010397:Penicillanic Acid; D005337:Fibrin; D013407:Sulbactam; D000078142:Tazobactam; D010878:Piperacillin