VOL.47 NO.5 Table 1. Susceptibility distribution of Ĉ- lactams against clinical isolates of MRSA MRSA: rnethicillin- resistant Staphylococcus aureus

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Transcription:

MAY 1999

VOL.47 NO.5 Table 1. Susceptibility distribution of ƒà- lactams against clinical isolates of MRSA MRSA: rnethicillin- resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ ml) FMOX: flomoxef, CPR: cefpirome, IPM: imipenem

MAY 1999 Table 2. Susceptibility distribution of vancomycin against clinical isolates of MRSA MRSA: methicillin- resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ ml) VCM: vancomycin Table 3. FIC index distribution of vancomycin in combination with flomoxef against MRSA - In relation to MIC of flomoxef- MRSA: methicillin- resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ ml) FMOX: flomoxef

VOL.47 NO.5 Table 4. FIC index distribution of vancomycin in combination with cefpirome against MRSA -In relation to MIC of cefpirome- MRSA: methicillin-resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ml) CPR: cefpirome Table 5. FIC index distribution of vancomycin in combination with imipenem against MRSA -In relation to MIC of imipenem- MRSA: methicillin-resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ml) IPM: imipenem

MAY 1999 Table 6. FIC index distribution of vancomycin in combination with ƒà-lactams against all 560 MRSA strains isolated in 1995 `1997 MRSA: methicillin-resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ml) FMOX: flomoxef, CPR: cefpirome, IPM: Imipenem Table 7. Decrease of each antibiotic MIC in the combinations of vancomycin with ƒà-lactams MRSA: methicillin-resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg ml) FMOX: flomoxef, CPR: cefpirome, IPM: imipenem

VOL.47 NO.5 Fig. 1. Bactericidal activities of vancomycin and flomoxef alone and in combinations against MRSA A- 1930. MRSA: methicillin resistant Staphylococcus aureus (oxacillin MIC: 4ƒÊg/ml)

MAY 1999 In vitro combination effects of vancomycin and ƒà-lactams against methicillin- resistant Staphylococcus aureus Yutaka Jinushi, Yoshiji Kimura, Tadashi Munekage, Isamu Yoshida and Shimaru Sasaki Discovery Research Laboratories, Shionogi and Co., Ltd., 3-1- 1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan We determined the in vitro combination effects of vancomycin (VCM) plus flomoxef (FMOX), VCM plus cefpirome (CPR), and VCM plus imipenem (IPM) by the checkerboard method on 560 methicillin-resistant Staphylococcus aureus (MRSA), which were clinically isolated in 1995, 1996 and 1997, and compared their MICs and fractional inhibitory concentration (FIC) index. For these three years, the antibacterial activities of VCM alone showed high levels against the 560 MRSA with the same MIC 90 of 1ƒÊg/ ml, and no strains detected of MIC with more than 4ƒÊg/ ml. During the same period, each ƒà- actam alone demonstrated the same antibacterial activities with the same MIC90 of 128ƒÊ/ ml,64,ug/ml and 64ƒÊg/ ml to FMOX, CPR and IPM, respectively. Combinations of VCM plus FMOX and of VCM plus IPM displayed synergistic effects, an FIC index of 0.5 against more than 90% of the strains, and additive effects, an FIC index from >0.5 to < 2.0 against all other strains. The combination of VCM plus CPR led to additive effects against most strains. None of the combinations showed antagonistic effects, an FIC index of 2.0, against any of the strains. By comparing the bactericidal activities against MRSA, the combinations of 0.5ƒÊg/ ml VCM plus 2, 4 and 8ƒÊg/ ml FMOX showed higher activities than that of each antibiotic alone. These results suggest that combination therapies of VCM plus FMOX and of VCM plus IPM can be useful in the treatment of MRSA infection.

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