title: In vitro activity of clarithromycin against penicillin-susceptible and penicillin-resistant strains of Streptococcus pneumoniae in a pharmacodynamic simulation model.
abstract: Clarithromycin has shown enhanced activity against Streptococcus pneumoniae, but increased resistance to macrolides has been observed in recent years. Our aim was to investigate its activity against strains of S. pneumoniae with variable susceptibility to this antibiotic and to penicillin. We determined killing curves using the Centriprep-10 pharmacodynamic simulation model, which permits using varying antibiotic concentrations to mimic a pharmacokinetic human profile in serum (corresponding to an oral dose of 500 mg). Four strains of S. pneumoniae were tested. In susceptible strains, clarithromycin showed bactericidal activity (reductions of up to 2.97 log10 cfu/ml of the initial inoculum). In resistant strains, clarithromycin showed a bacteriostatic effect (<1 log10 cfu/ml reduction). Penicillin-susceptible strains showed higher reductions than penicillin-resistant strains. This effect is important owing to the high minimum inhibitory concentration (MIC) of one of the resistant strains (32 microg/ml). More studies are needed to explain this bacteriostatic activity.
authors.affiliation: Department of Microbiology, School of Medicine, Complutense University, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Fuentes
authors.forename: D
authors.initials: D
authors.lastname: Sevillano
authors.forename: I P
authors.initials: IP
authors.lastname: Balcabao
authors.forename: M L
authors.initials: ML
authors.lastname: Gómez-Lus
authors.forename: J
authors.initials: J
authors.lastname: Prieto
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology*; D017291:Clarithromycin / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D008954:Models, Biological; D010403:Penicillin Resistance; D015610:Serum Bactericidal Test; D013296:Streptococcus pneumoniae / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin