title: In vitro synergistic effects of various combinations of vancomycin and non-beta-lactams against Staphylococcus aureus with reduced susceptibility to vancomycin.
abstract: The aim of our study was to determine the potential for synergistic effect of vancomycin combined with a non-beta-lactam agent and of combinations of orally available non-beta-lactam agents against vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA). Three VISA isolates, three hVISA isolates, and two vancomycin-susceptible S. aureus (VSSA) isolates were used. The combinations included vancomycin and one of clindamycin, ciprofloxacin, gentamicin, rifampicin, or trimethoprim/sulfamethoxazole. Pairwise combinations among five non-beta-lactam agents were also tested for synergy. Synergy was determined using time-kill curves at 24h. Vancomycin combined with either ciprofloxacin or gentamicin showed synergy against some isolates of VISA, hVISA and VSSA. Vancomycin combined with trimethoprim/sulfamethoxazole showed synergy against VISA and hVISA. Among orally available non-beta-lactam agents, only ciprofloxacin combined with either clindamycin or trimethoprim/sulfamethoxazole showed synergy against one isolate of VISA.
authors: Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea.
authors: Yu Ri
authors: YR
authors: Kang
authors: Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea; Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: iddrchung@gmail.com.
authors: Doo Ryeon
authors: DR
authors: Chung
authors: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Jungok
authors: J
authors: Kim
authors: Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea.
authors: Jin Yang
authors: JY
authors: Baek
authors: Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea.
authors: So Hyun
authors: SH
authors: Kim
authors: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Young Eun
authors: YE
authors: Ha
authors: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Cheol-In
authors: CI
authors: Kang
authors: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Kyong Ran
authors: KR
authors: Peck
authors: Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea; Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Jae-Hoon
authors: JH
authors: Song
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology; D004357:Drug Synergism; D006801:Humans; D008826:Microbial Sensitivity Tests; D050296:Microbial Viability / Q000187:drug effects; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Bactericidal activity; Drug resistance; Synergy; Time-kill study