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Journal of Antimicrobial Chemotherapy (2001) 47, 83-86
© 2001 The British Society for Antimicrobial Chemotherapy

Brief report

In vitro synergy between cefepime and vancomycin against methicillin-susceptible and -resistant Staphylococcus aureus and Staphylococcus epidermidis

Alain Lozniewski*, Christine Lion, Francine Mory and Michèle Weber

Laboratoire de Bactériologie, Hôpital Central, 29 Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex, France

The in vitro activity of cefepime combined with vancomycin was assessed by the chequerboard method against 35 clinical isolates of methicillin-susceptible (MSSA, n = 8) or -resistant (MRSA, n = 10) Staphylococcus aureus and methicillin-susceptible (MSSE, n = 9) or -resistant (MRSE, n = 8) Staphylococcus epidermidis and S. aureus ATCC 25923 (MSSA). The combination was synergic against 16 isolates and additive/indifferent against 20. For 10 of the clinical isolates (two MSSA, three MRSA, two MSSE, three MRSE) and the reference strain, the interaction of cefepime and vancomycin was also determined by the time–kill method. Except for one MRSA isolate, synergic killing was demonstrated with clinically achievable concentrations of vancomycin (0.5–1 mg/L) and cefepime (methicillin-susceptible isolates: 0.5–1 mg/L; methicillin-resistant isolates: 2–64 mg/L).

* Corresponding author. Tel: +33-3-83852196; Fax: +33-3-83852673; E-mail: a.lozniewski{at}chu-nancy.fr


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