title: In vitro synergistic effect of ciprofloxacin with aminoglycosides against multidrug resistant-Pseudomonas aeruginosa.
abstract: Pseudomonas aeruginosa is an increasingly prevalent nosocomial human pathogen. Infections with multidrug-resistant (MDR) P. aeruginosa are currently a treatment challenge and requires search for better treatment options.
  
  
  OBJECTIVE
  To determine in vitro synergistic effect of ciprofloxacin in combination with amikacin and gentamicin against MDR P. aeruginosa clinical isolates.
  
  
  METHODS
  Antibiotic resistance pattern of 100 identified clinical isolates of P. aeruginosa was determined against eight antibiotics by disc diffusion method at Microbiology Laboratory, Holy Family Hospital, Rawalpindi. For 30 selected MDR isolates, minimum inhibitory concentrations (MICs) of amikacin and gentamicin were determined separately by agar diffusion method followed by combined activity of ciprofloxacin with amikacin and gentamicin by checkerboard agar dilution technique.
  
  
  RESULTS
  Antibiotic resistance pattern of P. aeruginosa isolates was; gentamicin and carbenicillin (94%), amikacin and piperacillin (92%), ceftazidime (90%), colistin (87%), ciprofloxacin (79%) and imipenem (72%). MICs against 30 selected MDR isolates ranged from 32 to >128μg/mL for amikacin, and >128μg/mL for gentamicin. Synergistic effect was observed in 12/30(40%) isolates for AK+CIP and in 05/30 (16.7%) for CN+CIP.
  
  
  CONCLUSIONS
  Ciprofloxacin in combination with amikacin and gentamicin showed synergistic effect and no antagonistic effect against MDR P. aeruginosa.
authors.affiliation: Microbiology Laboratory, Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan.
authors.forename: Firdous
authors.initials: F
authors.lastname: Yasmin
authors.forename: Naeem
authors.initials: N
authors.lastname: Akhtar
authors.forename: Abdul
authors.initials: A
authors.lastname: Hameed
mesh_terms: D000583:Amikacin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D024901:Drug Resistance, Multiple, Bacterial; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005839:Gentamicins / Q000494:pharmacology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D000583:Amikacin