title: In vitro activities of co-amoxiclav at concentrations achieved in human serum against the resistant subpopulation of heteroresistant Staphylococcus aureus: a controlled study with vancomycin.
abstract: The effects of concentrations that simulated those in human serum after a single intravenous dose of amoxicillin (2 g), amoxicillin-clavulanic acid (2,000 and 200 mg, respectively), or vancomycin (500 mg), on the viability and beta-lactamase activity of two isogenic (beta-lactamase and non-beta-lactamase producer) heteroresistant Staphylococcus aureus strains were studied in an in vitro pharmacodynamic model. A reduction of > or = 97% of the initial inoculum was obtained with vancomycin and amoxicillin-clavulanic acid against both strains, with respect to the total bacterial population and the oxacillin-resistant subpopulation. The same pattern was observed with amoxicillin and the beta-lactamase-negative strain. beta-Lactamase activity in the beta-lactamase-positive strain changed over time parallel to viability, decreasing with amoxicillin-clavulanic acid or vancomycin and increasing in the amoxicillin and control groups. Clavulanic acid concentrations achievable in serum that changed over time allowed amoxicillin to act against the beta-lactamase-producing methicillin-resistant S. aureus to a similar extent as vancomycin.
authors.affiliation: Microbiology Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Prieto
authors.forename: L
authors.initials: L
authors.lastname: Aguilar
authors.forename: M J
authors.initials: MJ
authors.lastname: Giménez
authors.forename: D
authors.initials: D
authors.lastname: Toro
authors.forename: M L
authors.initials: ML
authors.lastname: Gómez-Lus
authors.forename: R
authors.initials: R
authors.lastname: Dal-Ré
authors.forename: I P
authors.initials: IP
authors.lastname: Balcabao
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000097:blood / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*; D014640:Vancomycin / Q000494:pharmacology; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D010406:Penicillins; D014640:Vancomycin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D001618:beta-Lactamases