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Journal of Antimicrobial Chemotherapy (1988) 22, 651-657
© 1988 The British Society for Antimicrobial Chemotherapy

research-article

Interaction between piperacillin and pefloxacin or amikacin on the selection of resistant mutants of Pseudomonas aeruginosa

A. Boisivona, C. Guiomara and L. Gutmannb

aService de Microbiologie, Hôspital de Saint Germain-en-Laye 78104, Saint Germain-en-Laye bService de Microbiologie, Hôspital Saint-Joseph 7, rue Pierre Larousse, 75674 Paris Cedex 14, France

Received 5 February 1988; returned 21 July 1988; accepted 21 July 1988

Pseudomonas aeruginosa mutants were selected with piperacillin, pefloxacin, amikacin and the combinations pefloxacin-piperacillin and amikacin-piperacillin. With amikacin and the piperacillin-amikacin combination no mutants were selected. With piperacillin (1–32 x MIC) mutants resistant to carboxypenicillins, ureidopenicillins, monobactam and cephalosporins were selected. With pefloxacin, three different types of mutant were observed which showed different patterns of cross-resistance to pefloxacin, sulphonamides, imipenem, piperacillin and other ß-lactam antibiotics. With the pefloxacin-piperacillin association, mutants similar to one of the types selected by pefloxacin alone and resistant to both of the selective antibiotic were predominantly obtained. No mutants were selected with this combination if one of the antibiotics was used at a concentration equal to its MIC for the wild type strain and the other at concentrations above 4 x MIC. Since the association of piperacillin and pefloxacin was only moderately bactericidal against the predominantly cross-resistant mutant selected, the concentration of these antibiotics may have to be carefully controlled to prevent the emergence of such mutants.


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