In-vitro activity of ciprofloxacin combined with flomoxef against Bacteroides fragilis, compared with that of ciprofloxacin combined with clindamycin.
Using checkerboard and time-kill assays, the in-vitro activity of ciprofloxacin alone and in combination with flomoxef against clinical Bacteroides fragilis strains was evaluated. In addition, the microbiological efficacy of this combination was compared with that of ciprofloxacin plus clindamycin. In 88% of the 25 strains tested, the combination of ciprofloxacin plus flomoxef exhibited a synergistic or an additive effect, whereas only 56% of the 25 strains ( P< 0.01, chi(2) test) tested with the combination of ciprofloxacin plus clindamycin exhibited similar effects. In a time-kill study using 7 clinical strains, a synergistic or additive effect of the combination of ciprofloxacin plus flomoxef was observed in all 7 strains. In conclusion, the combination of ciprofloxacin plus flomoxef is very active against B. fragilis, suggesting that this combination may be very useful in the treatment of aerobic and B. fragilis mixed infections, because ciprofloxacin has an expanded spectrum against aerobes.
Third Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo 173-8610, Japan. komei@med.nihon-u.ac.jp
Komei
K
Kato
Shigetomi
S
Iwai
Takeshi
T
Sato
Tomohide
T
Harada
Yoshiteru
Y
Nakagawa
Hitomi
H
Iwanaga
Yumiko
Y
Ito
Tadatoshi
T
Takayama
D001441:Bacteroides fragilis / Q000187:drug effects*; D002511:Cephalosporins / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D002981:Clindamycin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests
D002511:Cephalosporins; D002981:Clindamycin; D002939:Ciprofloxacin; C045693:flomoxef