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JAC Advance Access published online on September 6, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkf174
© 2002 by The British Society for Antimicrobial Chemotherapy
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© 2002 The British Society for Antimicrobial Chemotherapy

Original Paper

Clinical significance of inhibition kinetics for Streptococcus pyogenes in response to penicillin

Christoph Steininger 1, Franz Allerberger 2, Erich Gnaiger 3*

1 Department of Pediatrics, University Hospital Innsbruck, Innsbruck, Austria
2 Institute of Hygiene, University of Innsbruck, Innsbruck, Austria
3 Department of Transplant Surgery, D. Swarovski Research Laboratory, University Hospital Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria

* Corresponding author. E-mail: erich.gnaiger{at}uibk.ac.at.

Received 14 January 2002 ; revised 8 July 2002 ; accepted 15 July 2002

Abstract

Objectives: The antibiotic mode of action against clinical isolates of Streptococcus pyogenes and physiological factors involved in modifying the inhibitory response to the antibiotic were investigated.

Methods: We developed high-resolution respirometry for continuous monitoring of bacterial growth and inhibition kinetics. One hundred and ten clinical isolates from 90 paediatric patients were tested, including 48 isolates obtained from 28 patients with eradication failure. Respirometric inhibition curves were monitored at 4 mg/L penicillin G over a short 30 min period, corresponding to the drug's serum half-life.

Results: None of the clinical isolates exhibited penicillin tolerance. Latency in the respirometric response of S. pyogenes to penicillin increased significantly with decreasing strain-specific respirometric growth rate. No difference in inhibition kinetics was found in vitro for isolates from patients with or without bacteriological treatment failure.

Conclusions: In streptococcal pharyngotonsillitis, tolerance is not a relevant concept to explain bacteriological treatment failure. Definitions of tolerance should be reconsidered in the framework of growth-dependent antibiotic susceptibility.


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