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[Clinical observation of neonatal meningitis caused by flavobacterium meningosepticum].

From January 1981 to December 1988, we collected 11 cases of neonatal meningitis caused by Flavobacterium meningosepticum. The 6 male and 5 female newborns ranged from 3 days to 20 days old. Birth body weight varied from 1100 gm to 3600 gm. Seven cases were premature or small for date. Nosocomial infection was noted in 7 of these 11 cases. Clinically, lethargy and poor activity were the most common symptoms. Cyanosis, fever and convulsion were the next. There were 9 cases showing pleocytosis, increased protein and decreased glucose level in the cerebrospinal fluid examination. The organisms isolated in all 11 cases were susceptible to piperacillin, resistant to ampicillin, aminoglycosides and cephalosporin. Five patients were treated with antibiotics other than piperacillin for 5 to 18 days. Three patients died; hydrocephalus was the cause of death in 2 of them. Two patients were discharged against advice. Among the remaining 6 cases we gave piperacillin for 3 weeks, one case developed hydrocephalus but eventually succumbed to K. pneumoniae sepsis. Out of five surviving cases, 3 developed hydrocephalus (VP shunt performed in two). The other two patients were discharged without neurological deficit. In conclusion, neonatal Flavobacterium meningosepticum meningitis was more frequent in premature or small for date babies, and it usually appeared in nosocomial infection. The prognosis was poor and piperacillin was proved to be the drug of choice.

Female↗
PubMed1984

[Comparative activity of azlocillin on Pseudomonas species excluding Pseudomonas aeruginosa].

The minimal inhibitory concentrations (MIC) of three acylureidopenicillins (azlocillin, mezlocillin, piperacillin) and three third generation cephalosporins (cefotaxime, cefoperazone, cefsulodin) against 249 randomized strains of Pseudomonas spp. representing 10 species other than Pseudomonas aeruginosa, were determined by the agar dilution method in Mueller-Hinton agar and compared by parametric statistical tests. Fresh clinical and environmental hospital isolates belonged to the following species: P. fluorescens (35), P. putida (37), P. stutzeri (17), P. mendocina (4), P. cepacia (37), P. pickettii (22), P. acidovorans (36), P. diminuta (5), P. paucimobilis (23), P. maltophilia (37). Azlocillin inhibited over 88% of Pseudomonas spp at 64 mg/l or less. This good antipseudomonal activity in vitro was comparable to those of piperacillin and cefotaxime with a minimal inhibitory concentrations 50 value of 8 mg/l. Against these Pseudomonas spp, the ranking order of activity was azlocillin = piperacillin = cefotaxime greater than cefoperazone greater than mezlocillin greater than cefsulodin. Like piperacillin or cefotaxime, azlocillin, was effective against ticarcillin--and aminoglycoside--resistant Pseudomonas spp. Against P. maltophilia and P. cepacia, the two Pseudomonas spp other than P. aeruginosa that are important pathogens in opportunistic infections and in their vast majority are resistant to amino glycosides, azlocillin was significantly active. Only in the case of P. maltophilia, cefoperazone had a lower minimal inhibitory concentrations 50 (8 mg/l vs. 32 mg/l).

Anti-Bacterial Agents↗
PubMed1981

Antibiotic treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis patients.

The retrospective bacteriological results of 322 courses of anti-Pseudomonas aeruginosa chemotherapy in a cohort of 57 cystic fibrosis (CF) patients are reported. Tobramycin given as mono-therapy eradicated P. aeruginosa from the lungs of CF patients in 9% of the courses, whereas a combination therapy consisting of carbenicillin + tobramycin eradicated P. aeruginosa in 55% of the courses. However, the efficacy of the chemotherapy diminished successively when repeated courses of treatment were given. The efficacy of the carbenicillin + tobramycin combination in eradicating P. aeruginosa from the lungs of CF patients was compared with the efficacy of azlocillin + tobramycin and piperacillin + tobramycin in a prospective study. P. aeruginosa was eradicated in 78% of CF patients treated with carbenicillin + tobramycin, in 28% of CF patients treated with azlocillin + tobramycin, and in 33% of CF patients treated with piperacillin + tobramycin. However, the two latter groups of patients had on an average significantly higher numbers of P. aeruginosa precipitins in serum, indicating more severe infections. In CF patients where P. aeruginosa was not eradicated, a significant increase of MIC against carbenicillin, azlocillin and piperacillin was observed. There was a significant improvement of lung function and laboratory parameters reflecting diminished inflammation as a result of the treatment. 40% of the CF patients treated with azlocillin or piperacillin developed serum sickness-like symptoms.

Adolescent↗
PubMed1993

Cross-susceptibility of cefpirome and four other beta-lactams against isolates from haematology/oncology and intensive care units. International Study Group.

A multi-centre in-vitro study (8625 isolates) was conducted in 13 countries between May and November, 1992 to determine both the current bacterial epidemiology in intensive care and haematology/oncology units and the cross-susceptibility of the organisms to cefpirome, ceftazidime, ceftriaxone, imipenem and piperacillin. Bacterial species with 20 or more isolates resistant to one of the six antibiotics were examined for their susceptibility to the beta-lactams. Cefpirome and imipenem had the smallest total numbers of isolates. Bacteria resistant to ceftazidime or ceftriaxone were often susceptible (> 50%) to cefpirome. Conversely, cefpirome resistant isolates were frequently resistant (> 90%) to ceftazidime and ceftriaxone. P. aeruginosa was an exception, exhibiting cross-resistance to all cephalosporins. beta-lactamase producing Enterobacter, Citrobacter and Klebsiella spp. were especially resistant to piperacillin and ceftazidime but not cefpirome or imipenem. Two-thirds or more of coagulase-negative staphylococci resistant to any single agent, including imipenem, maintained their susceptibility to cefpirome. Cross-class resistance was not exhibited by imipenem and cefpirome against ciprofloxacin resistant isolates but was more evident for piperacillin, ceftazidime and ceftriaxone. Cefpirome was more active than ceftazidime against bacteria resistant to both piperacillin and gentamicin, especially coagulase-negative staphylococci (76% vs. 6%) and Enterobacter spp. (56% vs. 21%). Many coagulase-negative staphylococci and Enterobacter spp. susceptible to cefpirome (50-89%). These results suggest that cefpirome has a potential clinical advantage against gram-positive and gram-negative bacteria resistant to other beta-lactams, including imipenem.

Anti-Bacterial Agents↗
PubMed1980

Selection of variants of Pseudomonas aeruginosa resistant of Beta-lactam antibiotics.

In broth cultures of Pseudomonas aeruginosa, containing carbenicillin or azlocillin, regrowth occurred after a period of bactericidal action, to reach visible proportions overnight. Regrowth in the presence of relatively high concentrations of carbenicillin or azlocillin could not be accounted for on the basis of growth of resistant variants nor as a result of drug inactivation. On the other hand, resistant variants could be selected from the regrowth which occurred at concentrations of carbenicillin or azlocillin only slight in excess of the minimum inhibitory concentrations (MIC). Antibiotic resistant variants could also be isolated from individual colonies growing on agar plates containing carbenicillin, ticarcillin, azlocillin or piperaccillin at concentrations above the MIC for the majority of the population. Two types of resistant variant were isolated. The first showed a 2-5 fold increase in resistance to carbenicillin, ticarcillin, azlocillin and piperacillin while Beta-lactamase production in these variants appeared to be unchanged. The second type of resistant variant showed unchanged sensitivity to carbenicillin and ticarcillin, or only a slight increase in resistance, whereas resistance to azlocillin and piperacillin was increased as much as 40-fold or more. These variants showed increased constitutive Beta-lactamase production and may be derepressed mutants of the parent culture. Variants of this type were readily selected by culture in the presence of azlocillin or piperacillin but only infrequently as a result of culture in the presence of carbenicillin or ticarcillin. The existence in cultures of P. aeruginosa of variants showing elevated Beta-lactamase production may account at least in part for the effect of inoculum size on the activity of azlocillin and piperacillin against P. aeruginosa and the marked discrepancy between MIC and minimum bactericidal concentration (MBC) which is characteristic of the ureido penicillins.

Animals↗
PubMed2000

Determination of intracellular and extracellular beta-lactamase activities of Pseudomonas aeruginosa after exposure to beta-lactams in vitro and in vivo.

Beta-lactamase production in Pseudomonas aeruginosa was determined in in-vitro models and in rat pouch infection models after exposure to ceftazidime, imipenem, and piperacillin. Exposure of 28 P. aeruginosa strains to 1/4 minimum inhibitory concentration (MIC) of ceftazidime, imipenem, and piperacillin for 24 h enhanced intracellular beta-lactamase activities in 14, 22, and 6 strains, respectively, of the 28 clinical strains tested, and enhanced extracellular beta-lactamase activities which were not detected without exposure to antibiotics, in 7, 23, and 1 of the 28 strains, respectively. Extracellular beta-lactamase activity from P. aeruginosa S-1278, producing an inducible beta-lactamase, scarcely increased after exposure to ceftazidime and piperacillin 24 h after incubation, while the activity increased after exposure to imipenem over the range of 1/8 to 8 MIC. In the rat granuloma pouch models infected with P. aeruginosa S-1278, ceftazidime and piperacillin, after single administration (20 mg/kg) and serial administration (20 mg/kg per day x 3 days), did not enhance extracellular beta-lactamase activities. However, the activities were enhanced with single and serial administrations of imipenem, and levels over 10 mU/ml were detected until the third day. The beta-lactamase activity, similar to the activity found in rat pouches after serial administration of imipenem, inactivated various cephalosporins. In conclusion, extracellular beta-lactamase activity was detected both in vitro and in vivo after exposure to a good inducer, and extracellular beta-lactamase remained at infection site at levels that could inactivate cephalosporins.

Animals↗
PubMed1988

Basophil histamine release remains unaffected by clinical desensitization to penicillin.

A penicillin-allergic patient who required therapy with beta-lactam antibiotics was desensitized with increasing parenteral doses of benzylpenicillin. After desensitization, the patient tolerated, without signs of allergic reaction, intravenous piperacillin. Immunologic studies were undertaken to investigate humoral and cellular changes accompanying desensitization. Serum penicilloyl IgG and IgE antibodies did not change significantly during induction of clinical tolerance to the drug. The patient's previously positive immediate skin reaction to penicilloyl polylysine (PPL) converted to negative. Nonspecific releasability of skin mast cells as tested with polymyxin B skin test was unchanged. In contrast, in vitro blood basophil activation, both by specific antigen (penicilloyl-human albumin) and a nonspecific IgE-dependent stimulus (anti-IgE) remained strong after the desensitization procedure and during weeks of high-dose piperacillin therapy. A monovalent penicilloyl hapten inhibited penicilloyl-albumin-induced basophil histamine release, whereas the patient's own serum taken while the patient was receiving treatment did not. Moreover, the patient's treatment serum, while the patient was receiving piperacillin, was able to trigger histamine release from passively sensitized basophils of a donor not allergic to penicillin, suggesting the presence of a sufficient amount of complete multivalent antigen to initiate release and/or desensitization. The presence of high concentrations of penicilloated serum proteins in the patient's treatment serum was confirmed by immunoassay. Basophil histamine release could, nevertheless, be elicited from the patient's whole blood sample taken while the patient was receiving piperacillin treatment by adding penicilloyl-human albumin in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Combination of ofloxacin and other antimicrobial agents.

We evaluated the combination of ofloxacin with piperacillin, gentamicin, vancomycin, rifampin, clindamycin, and metronidazole by the checkerboard agar dilution method against 165 isolates which included Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Pseudomonas aeruginosa, Providencia stuartii, Acinetobacter, Staphylococcus aureus, Bacteroides fragilis, and Citrobacter perfringens. Synergy of piperacillin-ofloxacin was demonstrated for 50% and 40% respectively of E. cloacae and P. aeruginosa. Some ofloxacin and piperacillin-resistant isolates were susceptible with the combination. Ofloxacin-gentamicin was indifferent for aerobic gram-negative species. Ofloxacin and vancomycin or gentamicin was indifferent for S. aureus and E. faecalis, but rifampin-ofloxacin showed addition. Combination of ofloxacin and metronidazole or clindamycin or erythromycin was indifferent for aerobic and anaerobic species. Ofloxacin could be combined with piperacillin with benefit against P. aeruginosa, but combination with aminoglycosides is not of benefit.

Anti-Infective Agents↗
PubMed1989

Comparative in-vitro activity of the penem FCE 22101 against recent European blood culture isolates.

Recent blood culture isolates (462 strains of Gram-negative bacilli and 288 strains of staphylococci) collected in 30 European laboratories were tested for susceptibility to five beta-lactam antibiotics by a microdilution method in Mueller-Hinton broth. The penem FCE 22101 and imipenem were very active against the Gram-negative bacilli, except the pseudomonads, FCE 22101 being four- to 16-fold less active (MIC50 2 mg/l; MIC90 8 mg/l) than imipenem MIC50 0.5 mg/l; MIC90 2 mg/l). Ceftibuten and ceftazidime were also active (MIC50 0.25 mg/l; MIC90 greater than 16 mg/l). The MIC of piperacillin (MIC50 8 mg/l; MIC90 greater than 64 mg/l) were two- to 16-fold reduced in the presence of the beta-lactamase inhibitor YTR-830 against these bacteria. Only imipenem and piperacillin inhibited the pseudomonads (MIC50 4 and 8 mg/l respectively; MIC90 16 mg/l and greater than 64 mg/l), with two-fold reduction in MIC50 of piperacillin in the presence of YTR-830. The staphylococci were very susceptible to FCE 22101 and imipenem (MIC50 less than or equal to 0.25 mg/l) except some cefazolin-resistant strains. In Staphylococcus aureus penem resistance was better expressed after bacterial growth at 30 degrees C. Some strains of Staph. epidermidis were susceptible to FCE 22101 but resistant to imipenem. The cephalosporins were not active against the staphylococci, and the presence of YTR-830 caused a four- to 16-fold reduction in MIC of piperacillin.

Anti-Bacterial Agents↗
PubMed1991

Synergic post-antibiotic effect of mecillinam, in combination with other beta-lactam antibiotics in relation to morphology and initial killing.

The synergic in-vitro post-antibiotic effect (PAE) of mecillinam, in combination with either ampicillin, aztreonam, ceftazidime or piperacillin, on a reference strain of Escherichia coli was evaluated by bioluminescence assay of bacterial ATP. Ampicillin, ceftazidime and mecillinam alone induced a concentration dependent PAE (greater than 3 h) on E. coli, whereas aztreonam and piperacillin alone induced a short (less than 1 h) non-dose dependent PAE. At most concentrations, the combination of mecillinam and ampicillin, aztreonam, ceftazidime or piperacillin induced longer PAEs on E. coli than the sum of the individual antibiotics' PAEs. Long PAEs were seen concomitantly with the presence of spheroplasts. In addition to the synergistic PAE, the decrease in colony counts and changes in ATP values after a 2 h exposure to mecillinam, in combination with the other beta-lactam antibiotics, were more prominent than the respective values after exposure to the individual antibiotics. The change in ATP was generally less pronounced than the decrease in colony counts. This could be due to lysis of spheroplasts on agar plates, leading to an over-estimation of the initial killing when assayed by viable counting. Mecillinam, which induced long PAEs on E. coli at almost all concentrations in this study, has a high affinity for penicillin binding protein 2 (PBP 2) and induced spheroplast formation at all concentrations. However, mechanisms other than the affinity for PBP 2 and spheroplast formation are involved in the PAE of beta-lactam antibiotics on Gram-negative bacteria; since the PAE was prolonged when mecillinam was combined with ampicillin, aztreonam, ceftazidime or piperacillin, which bind preferentially to PBP 1 and 3.

Adenosine Triphosphate↗
PubMed1999

New species-related MIC breakpoints for early detection of development of resistance among gram-negative bacteria in Swedish intensive care units.

The frequency of decreased antibiotic susceptibility among 534 Gram-negative aerobic bacilli from patients admitted to intensive care units at eight hospitals in Sweden during 1997 was evaluated. MICs of cefepime, ceftazidime, ceftriaxone, ciprofloxacin, gentamicin, imipenem and piperacillin-tazobactam were determined using Etest. Reduced susceptibility (resistant and intermediate/indeterminate susceptible strains) was defined according to the MIC breakpoints of the British Society for Antimicrobial Chemotherapy (BSAC), the National Committee for Clinical Laboratory Standards (NCCLS) and the new species-related breakpoints of the Swedish Reference Group for Antibiotics (SRGA). The BSAC/NCCLS/SRGA breakpoints for susceptible category (mg/L) of Enterobacteriaceae are: cefepime, not available (NA)/8/0.5; ceftazidime, 2/8/2; ceftriaxone, NA/8/0.5; ciprofloxacin, 1/1/0.12; gentamicin, 1/4/2; imipenem, 4/4/1; and piperacillin-tazobactam, NA/16/16. The most frequently isolated organisms were Escherichia coli (n = 160; 30%), Klebsiella spp. (n = 84; 16%), Enterobacter spp. (n = 77; 14%), Pseudomonas aeruginosa (n = 64; 12%) andProteus spp. (n = 28; 5%). Decreased susceptibility among E. coliusing the BSAC/NCCLS/SRGA respective breakpoints (%) were: cefepime, NA/0/2; ceftazidime, 2/2/2; ceftriaxone, NA/1/2; ciprofloxacin, 2/2/8; gentamicin, 21/0/3; imipenem, 0/0/2; and piperacillin-tazobactam, NA/4/4. Corresponding levels of decreased susceptibility (%) among Klebsiellaspp. were: cefepime, NA/0/5; ceftazidime, 2/1/2; ceftriaxone, NA/1/10; ciprofloxacin, 4/4/19; gentamicin, 25/2/5; imipenem, 0/0/0; and piperacillin-tazobactam, NA/10/10; and among Enterobacter spp. were: cefepime, NA/1/19; ceftazidime, 30/29/30; ceftriaxone, NA/30/36; ciprofloxacin, 3/3/15; gentamicin,18/0/0; imipenem, 0/0/5; and piperacilllin-tazobactam, NA/27/27. In conclusion, the species-related SRGA breakpoints detected Gram-negative isolates with decreased susceptibility in comparison with the native population with higher frequency than did the NCCLS breakpoints. The BSAC breakpoints for susceptible organisms were similar to NCCLS for ciprofloxacin and imipenem, and similar to SRGA for ceftazidime but lower than both NCCLS and SRGA for gentamicin, causing a much higher frequency of decreased susceptibility to gentamicin.

Anti-Bacterial Agents↗
PubMed1991

Pseudomonas pseudomallei, a common pathogen in Thailand that is resistant to the bactericidal effects of many antibiotics.

The purpose of this investigation was to identify newer antimicrobial agents that may be useful in the therapy of melioidosis. The in vitro susceptibilities of 199 clinical isolates of Pseudomonas pseudomallei to 22 antibiotics were determined by standard disk diffusion, and those to 13 antibiotics were determined by agar dilution. Over 90% of the isolates were susceptible to imipenem, piperacillin-tazobactam, piperacillin, ceftazidime, ticarcillin-clavulanate, ampicillin-sulbactam, and carumonam by both methods. Standard disk diffusion yielded unacceptably high false-susceptibility results with aztreonam, ciprofloxacin, and temafloxacin. Piperacillin, ceftazidime, imipenem, and ciprofloxacin were not bactericidal for three selected P. pseudomallei strains as determined by time-kill curve methods. Furthermore, addition of ciprofloxacin to piperacillin, ceftazidime, or imipenem did not enhance bactericidal activity. One hundred ninety-four strains showed weak beta-lactamase production that did not increase upon incubation with cefoxitin. These findings suggest that several newer antimicrobial agents may prove useful in the treatment of melioidosis. However, results of susceptibility studies involving P. pseudomallei and newer agents must be interpreted with caution.

Anti-Bacterial Agents↗
PubMed1992

Survey of Bacteroides fragilis group susceptibility patterns in Canada.

The in vitro activities of penicillin, clindamycin, chloramphenicol, metronidazole, piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate, ampicillin-sulbactam, cefoxitin, ceftizoxime, cefotetan, moxalactam, and imipenem against 348 Bacteroides fragilis group isolates collected from six Canadian cities during 1990 were determined by the National Committee for Clinical Laboratory Standards (NCCLS) agar dilution technique. All isolates were susceptible to chloramphenicol, metronidazole, piperacillin-tazobactam, and imipenem. For the other antibiotics tested, the following resistance rates were observed: penicillin, 97%; clindamycin, 9%; piperacillin, 19%; ticarcillin, 31%; ticarcillin-clavulanate, 0.28%; ampicillin-sulbactam, 0.85%; cefoxitin, 26%; ceftizoxime, 15%; cefotetan, 53%; and moxalactam, 17%. Susceptibility profiles to beta-lactam antibiotics varied among the different species tested: B. fragilis and Bacteroides vulgatus demonstrated lower resistance rates than Bacteroides distasonis and indole-positive Bacteroides thetaiotaomicron and Bacteroides ovatus. Ceftizoxime results should be interpreted cautiously, because the MICs obtained with the recommended NCCLS control strain were lower than expected.

Anti-Bacterial Agents↗
PubMed1992

Effects of CO2 and pH on inhibition of TEM-1 and other beta-lactamases by penicillanic acid sulfones.

Incubation in 5% CO2 reduced the inhibition zones of piperacillin-tazobactam (75/10 micrograms) disks for Escherichia coli strains with TEM-1, TEM-2, and SHV-1 beta-lactamases. Similarly, MICs of piperacillin-tazobactam and other penicillin-sulfone combinations for TEM producers were up to 500-fold higher at pH 6.5 than at pH 8.0. This effect was greatest for organisms with high levels of enzyme activity. CO2 and mild acidity did not affect the susceptibility of beta-lactamase-negative strains to penicillin-sulfone combinations, and the effects of these conditions were variable for organisms with beta-lactamases other than TEM-1, TEM-2, and SHV-1. These last observations discounted acid-mediated inactivation of piperacillin or tazobactam. MICs of amoxicillin or piperacillin alone or with clavulanate for TEM and SHV producers were affected only less than or equal to 16-fold by 5% CO2 or acidity, indicating that the greater effects seen with the penicillin-sulfone combinations depended on the behavior of the sulfones and not on that of the penicillins. This pH effect was studied in detail for TEM-1 enzyme. Inhibition of this enzyme by sulfones but not clavulanate varied grossly with pH, with 50% inhibitory concentrations of tazobactam and sulbactam up to 300-fold higher at pH 6.5 than at 8.0. By contrast, the hydrolytic activity of TEM-1 enzyme for substrates and its level of production varied threefold or less between pH 6.5 and pH 8.0. Increased inhibition at pH 8.0 reflected sequestration of the enzyme into a secondary noncovalent complex rather than increased irreversible inactivation.

Carbon Dioxide↗
PubMed1995

Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci.

This study examined bacteriostatic and bactericidal activities of oral and parenteral antibiotics for penicillin-susceptible and intermediately and fully penicillin-resistant pneumococci. beta-Lactamase inhibitors did not affect beta-lactam results. The activities of ampicillin, amoxicillin +/- clavulanate, WY-49605, cefuroxime, cefpodoxime, cefdinir, cefixime, and cefaclor against two penicillin-susceptible, two intermediately penicillin-resistant, and two fully penicillin-resistant pneumococcal strains were tested. For all three groups, bacteriostatic values of amoxicillin and WY-49605 were lower than were those of other beta-lactams tested. Of the cephalosporins, cefdinir, cefuroxime, and cefpodoxime yielded the lowest bacteriostatic values. All beta-lactams were bactericidal (reduced original counts by > or = 3 log10 CFU/ml) at 1 dilution above bacteriostatic values, except for cefpodoxime (bactericidal at 2 dilutions above bacteriostatic values for one susceptible strain and one intermediately resistant strain), cefuroxime (bactericidal at 2 dilutions above bacteriostatic values for one intermediately resistant strain), and ampicillin (bactericidal at 2 dilutions above bacteriostatic values for one intermediately resistant strain). The activities of piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate, ampicillin, ampicillin-sulbactam, ceftriaxone, ceftazidime, and ciprofloxacin against four penicillin-susceptible, two intermediately penicillin-resistant, and four fully penicillin-resistant pneumococcal strains were evaluated. Bacteriostatic values of piperacillin, ampicillin, and ceftriaxone for all groups were lower than were those of ticarcillin and ceftazidime. Bacteriostatic values of ciprofloxacin were unaffected by penicillin susceptibility. All beta-lactams were bactericidal at 1 dilution above the bacteriostatic value, except for piperacillin (bactericidal at 2 dilutions above the bacteriostatic value for one intermediately resistant strain), ticarcillin (bactericidal at 2 dilutions above the bacteriostatic value for one susceptible strain and one resistant strain), ampicillin (bactericidal at 2 dilutions above the bacteriostatic value for two resistant strains), ceftriaxone (bactericidal at 2 dilutions above the bacteriostatic value for one resistant strain), and ceftazidime (bactericidal at 2 dilutions above the bacteriostatic value for one susceptible strain).

Administration, Oral↗
PubMed2004

Antianaerobic activity of a novel fluoroquinolone, WCK 771, compared to those of nine other agents.

Agar dilution MIC methodology was used to compare the activity of WCK 771 with those of ciprofloxacin, levofloxacin, moxifloxacin, gatifloxacin, piperacillin, piperacillin-tazobactam, imipenem, clindamycin, and metronidazole against 350 anaerobes. Overall, the MICs (in micrograms per milliliter) at which 50 and 90%, respectively, of the isolates tested were inhibited were as follows: WCK 771, 0.5 and 2.0; ciprofloxacin, 2.0 and 32.0; levofloxacin, 1.0 and 8.0; gatifloxacin, 0.5 and 4.0; moxifloxacin, 0.5 and 4.0; piperacillin, 2.0 and 64.0; piperacillin-tazobactam, < or =0.125 and 8.0; imipenem, 0.125 and 1.0; clindamycin, 0.125 and 16.0; and metronidazole, 1.0 and >16.0.

Anti-Infective Agents↗
PubMed1989

Pseudomonas aeruginosa: in vivo (murine) activity of five antimicrobial drugs, with and without human IgG immunoglobulin preparations.

Five antimicrobial drugs (ceftazidime, ciprofloxacin, imipenem, piperacillin and tobramycin) and two human, intravenously applicable, IgG immunoglobulin preparations (Psomaglobin, Polyglobin N) were examined alone and in various combinations for therapeutic efficacy in myelosuppressed as well as normal NMRI mice following systemic infection with 4 selected strains of Pseudomonas aeruginosa. Both IgG preparations alone invariably failed to passively protect neutropenic and normal mice, even though the preparations contained demonstrable antibodies against purified exotoxin A of P. aeruginosa and against numerous polypeptide and lipopolysaccharide constituents of the 4 test strains of P. aeruginosa. Among the antimicrobial drugs employed alone, ciprofloxacin and imipenem were the most effective. Tobramycin alone occupied an intermediate position, whereas monotherapy with ceftazidime and piperacillin invariably failed. All antimicrobial drug combinations were efficacious in myelo-suppressed as well as normal mice. Both IgG preparations failed to enhance the activities of ceftazidime and piperacillin in neutropenic mice; the activity of tobramycin was augmented against 1 of 2 P. aeruginosa strains, as well as that of ciprofloxacin. Both IgG preparations enhanced the activities of ceftazidime and tobramycin in normal NMRI mice, as well as that of piperacillin against 1 of 2 test strains. It was concluded that the two IgG preparations were more beneficial for normal rather than neutropenic mice, provided that the animals were treated with appropriate antimicrobial drugs as well.

Animals↗
PubMed1994

Allergic reactions to parenteral beta-lactam antibiotics in patients with cystic fibrosis.

Certain antibiotics, particularly piperacillin, have been reported to be associated with a high incidence of allergic reactions in patients with cystic fibrosis. We initiated a study to determine the relative frequency of allergic reactions, ie, drug-induced fever and rash, to parenteral beta-lactam antibiotics in adult patients with cystic fibrosis. Charts of 111 patients were reviewed for each hospitalization to assess allergic reactions. Of 90 evaluable patients, 26 patients developed one or more allergic reactions to beta-lactam antibiotics. The number of allergic reactions per number of patients receiving specific antibiotics were carbenicillin (4/56), mezlocillin (7/42), piperacillin (11/31), ticarcillin (1/20), cefazolin (0/24), ceftazidime (1/35), imipenem/cilastatin (4/16), and nafcillin (3/36). The mean time to onset of drug-induced fever or of rash was 9.1 days. As a group penicillins had a higher frequency of allergic reactions than cephalosporins. The frequency of reactions was greatest with acylaminopenicillins (mezlocillin and piperacillin) and imipenem/cilastatin. The results of this study indicate that in addition to piperacillin, mezlocillin and imipenem/cilastatin may be associated with a high incidence of allergic reactions in patients with CF.

Adult↗