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Journal of Antimicrobial Chemotherapy (1999) 44, 719-720
© 1999 The British Society for Antimicrobial Chemotherapy

Correspondence

The effects of the level of ampicillin resistance and the inoculum size on the in-vitro bactericidal activity of the combination of ampicillin and ciprofloxacin against high-level gentamicin-resistant strains of Enterococcus faecium

J Antimicrob Chemother 1999; 44: 719–720

M. F. Tripodia,*, A. Rambaldia, G. Sarnataroa, E. Ragone a and R. Utilib

a Institute of Medical Therapy b Department of Tropical Diseases, Second University of Naples, Naples, Italy

Sir,

Optimal therapy of patients with infections caused by high-level gentamicin-resistant (HLGR) enterococci remains to be determined. A combination of ampicillin and ciprofloxacin has been shown to be bactericidal in vitro against HLGR strains exhibiting low-level resistance to ciprofloxacin (MICs<= 4 mg/L),1 but, in an endocarditis animal model, failed to sterilize vegetations infected with a HLGR strain of Enterococcus faecium which was also highly resistant to ampicillin.2 We have recently reported that the in-vitro activity of this combination was influenced by the composition of the medium in which the activity was evaluated, i.e. ampicillin together with ciprofloxacin exhibited bactericidal activity in Mueller–Hinton broth (MHB), but only bacteriostatic activity . . . [Full Text of this Article]

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