title: High resistance of Pseudomonas aeruginosa to paromomycin, an agent used for selective bowel decontamination (SBD).
abstract: BACKGROUND
  Paromomycin is used for selective bowel decontamination (SBD) in patients undergoing bone marrow transplantation in many hospitals, but there are no published resistance data for this compound in the recent medical literature. The aim of this study was to investigate the in vitro activity of paromomycin against the common intestinal bacteria E. coli and P. aeruginosa.
  
  
  METHODS
  94 E. coli isolates and 77 P. aeruginosa isolates derived from clinical specimens were tested by broth microdilution against paromomycin and amikacin, respectively, following the CLSI recommendations for testing amikacin.
  
  
  RESULTS
  86 of 94 E. coli isolates (91%) and 71 of 77 P. aeruginosa isolates (92%) showed in vitro susceptibility to amikacin (MIC90 for both compounds: 16 µg/ml, range: 1-32 µg/ml for E. coli and 1->128 µg/ml for P. aeruginosa). Paromomycin was active against 83/94 E. coli isolates (88%; MIC90: 32 µg/ml, range: 2->128 µg/ml), but showed poor in vitro activity against P. aeruginosa (3/77 isolates susceptible [4%]; MIC90: >128 µg/ml, range: 2->128 µg/ml).
  
  
  CONCLUSIONS
  If SBD with inclusion of an aminoglycoside antibiotic is applied, paromomycin should not be used unless local resistance data provide evidence of a sufficient in vitro activity of this compound against P. aeruginosa.
authors: Clinical Institute for Hospital Hygiene, Medical University of Vienna, Austria.
authors: Florian
authors: F
authors: Daxboeck
authors: Werner
authors: W
authors: Rabitsch
authors: Maria
authors: M
authors: Stadler
authors: Ojan
authors: O
authors: Assadian
authors: Johannes
authors: J
authors: Leitgeb
keywords: E. coli; P. aeruginosa; minimal inhibitory concentration (MIC); paromomycin; selective bowel decontamination (SBD)
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