JAC Advance Access published online on April 14, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg238
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Division of Pediatric
Infectious Diseases
* Corresponding author. E-mail: agnesdawis{at}pol.net.
Received 16 October 2002
; revised 17 December 2002
; accepted 4 March 2003
Objectives: To study the in
vitro interaction of gatifloxacin in combination with gentamicin
and with the Methods: The activity of each drug alone was
determined by an agar dilution method. Chequerboard synergy testing
was then performed against all the isolates. Time-kill
assays were done on selected isolates to assess correlation with
the chequerboard results. Results: Synergy was demonstrated with the following
combinations at achievable serum concentrations: gatifloxacin/piperacillin
for 80% and gatifloxacin/cefepime for 60% of
S. maltophilia; gatifloxacin/gentamicin
for 60%, and gatifloxacin/cefepime for 50% of
ESBL-producing K. pneumoniae, and in all drug combinations
for 50-70% of P. aeruginosa.
Indifference was noted for the majority of B. cepacia and
VRE isolates. Antagonism at therapeutic serum levels was observed
with gatifloxacin/piperacillin against a single isolate of B.
cepacia. No distinct trend in drug interaction was seen with
the different drug combinations against MRSA. Time-kill
analyses against selected isolates confirmed the synergic activity
of the following drug combinations seen in the chequerboard assays:
gatifloxacin/cefepime and gatifloxacin/piperacillin against P.
aeruginosa, gatifloxacin/gentamicin against B.
cepacia, and gatifloxacin/gentamicin and gatifloxacin/meropenem
against ESBL-producing K. pneumoniae. Conclusions: Gatifloxacin was synergic with
the
Keywords: synergy, fluoroquinolones, gatifloxacin, susceptibility
testing
In vitro activity of gatifloxacin
alone and in combination with cefepime, meropenem, piperacillin
and gentamicin against multidrug-resistant organisms
2 Department
of Pathology
3 Center for
Clinical Laboratories, Mount Sinai School of Medicine, New York, NY, USA
-lactams cefepime, meropenem
and piperacillin against clinical isolates of Stenotrophomonas
maltophilia, Pseudomonas aeruginosa, Burkholderia
cepacia, extended-spectrum -lactamase
(ESBL)-producing Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium (VRE) and methicillin-resistant Staphylococcus aureus (MRSA).-lactams piperacillin, cefepime
and meropenem, and with gentamicin against some drug-resistant pathogens.
Some of the time-kill analyses against P. aeruginosa, B. cepacia and ESBL-producing K. pneumoniae were
in accordance with chequerboard results. Time-kill analyses
against S. maltophilia did not confirm the synergy
seen in chequerboard testing.
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