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Journal of Antimicrobial Chemotherapy (1999) 44, 418-420
© 1999 The British Society for Antimicrobial Chemotherapy

Correspondence

Effect of antibiotic concentration on the killing of Staphylococcus aureus and Enterococcus faecalis: comparison of the novel penem, Men 10700, with other ß-lactam antibiotics

J Antimicrob Chemother 1999; 44: 418–420

J. M. T. Hamilton-Miller* and Saroj Shah

Department of Medical Microbiology, Royal Free and University College Medical School, Pond Street, London NW3 2QG, UK

Sir,

The so-called `paradoxical effect`, whereby antibiotics exhibit reduced bactericidal activities at high drug concentrations, has been observed mainly, although not exclusively, with ß-lactams and Gram-positive bacteria.1 The phenomenon was first described by Eagle & Musselman2 who found that Staphylococcus aureus, ß-haemolytic streptococci and, most strikingly, Enterococcus faecalis were killed much more slowly by high concentrations of benzylpenicillin than by lower (but still supra-MIC) concentrations.

The data sheets for many antibiotics recommend the administration of higher dosages when an infection is deemed `serious` and it is apparent that for ß-lactam antibiotics in particular, there is a theoretical . . . [Full Text of this Article]

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