[Experimental models: interaction of Synercid with other anti-Gram positive agents].
In case of resistance to quinupristin, the bacteriostatic synergism is preserved but the in vivo bactericidal effect of Synercid declines. On the other hand, no selection of resistant mutants has been observed. In case of isolated resistance to dafopristin, there is no reduction in the bactericidal effect of Synercid; there is however a possible risk of selecting resistant mutants. To become resistant to Synercid, S. aureus strains have to become resistant to both quinupristin and dafopristin, a highly unlikely situation. POTENTIAL COMBINATIONS: Among the combinations of Synercid with other antibiotics, the combination with vancomycin would have particular interest for clinical applications, increasing bactericidal activity. This would be the case for severe S. aureus infections with a large inoculum and even more so for meti-R resistant strains with a C-MLSB phenotype. Combination with rifampicin would be another possibility, but only for strains not resistant to quinupristin.
Fantin
B
B
INSERM EMI 9933, Paris.
D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018432:Drug Resistance, Multiple; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006095:Gram-Positive Cocci / Q000187:drug effects*; D006801:Humans; D007769:Lactams; D008826:Microbial Sensitivity Tests; D014769:Virginiamycin / Q000009:adverse effects / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D007769:Lactams; D014769:Virginiamycin; C062940:quinupristin-dalfopristin
Apports des modèles expérimentaux: associations Synercid et autres agents anti-Gram positif.