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Journal of Antimicrobial Chemotherapy (1995) 36, 241-246
© 1995 The British Society for Antimicrobial Chemotherapy

brief-report

Bactericidal effect of ß-lactams and amikacin alone or in association against Klebsiella pneumoniae producing extended spectrum ß-lactamase

M. Roussel-Delvalleza, D. Sirotb, Y. Berrouanea, M. Goffarta, B. Gourdea, F. Walleta and R. J. Courcola

aLab. Bacteriologie-virologie-hygiine, Hopital A. Calmette 59037Lille bLab. Bacteriologies C. H. R, Hotel Dieu Clermont-Ferrand, France

Received 14 February 1994; returned 26 September 1994; accepted 5 January 1995

Ten extended spectrum ß-lactamases producing strains of Klebsiella pneumoniae characterized by analytical isoelectric focusing and studied for their susceptibility to /Mactam antibiotics, either alone or in combination with a ß-lactamase inhibitor (clavulanic acid and sulbactam) and in association with amikacin. The extended spectrum ß-lactamases were derived from either TEM (CTX-1 = TEM-3) or SHV (CAZ-4 = SHV-5). Killing curves were studied with antibiotics at clinical by achievable concentrations, at MIC and MIC x 4. At MIC, cefotetan, cefotaxime and ceftazidime lacked bactericidal activity. Imipenem was more rapidly bactericidal than meropenem or co-amoxiclav. At MIC x 4, cefotetan and cefotaxime exhibited bactericidal effect but this was less than for imipenem which gave a reduction of 4 log10 of the inoculum. Cefotaxime plus sulbactam gave no bactericidal effect compared with cefotaxime plus co-amoxiclav. A bactericidal effect with cefotaxime plus sulbactam was seen with the addition of amikacin. At clinical concentrations cefotaxime plus co-amoxiclav ± amikacin was as efficient as imipenem ± amikacin with arapid bactericidal effect (5–6 log10 in 30–60 min). We proposed that cefotaxime +- co-amoxiclav might be considered as an alternative to imipenem for the treatment of extended spectrum ßMactamase associated K. pneumoniae injections.


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Home page
 Clin. Microbiol. Rev.Home page
D. L. Paterson and R. A. Bonomo
Extended-Spectrum {beta}-Lactamases: a Clinical Update
Clin. Microbiol. Rev., October 1, 2005; 18(4): 657 - 686.
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