JAC Advance Access published online on January 16, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh080
© 2004 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Department of Medicine, National
Cheng Kung University Medical College; Department of Internal Medicine, National
Cheng Kung University Hospital, Tainan, Taiwan
* Corresponding author. E-mail: chuangkenneth{at}hotmail.com.
Received 19 August 2003
; revised 17 November 2003
; accepted 18 November 2003
Objectives: The potential therapeutic
role of meropenem combined with sulbactam against a clinical endemic
isolate of multidrug-resistant Acinetobacter baumannii,
Ab-153, was investigated. Methods: The antimicrobial susceptibility of
Ab-153 to various drugs was studied by the agar dilution method
and Etest strips. The antibacterial activity of meropenem and sulbactam
were investigated by a time-kill study in vitro and
further examined for therapeutic efficacy in vivo in
a murine model. Results: In the time-kill study, at
a concentration of 0.5 x MIC (4 mg/L)
of meropenem, 1 x MIC (8 mg/L) of sulbactam
and both in combination, only the combination demonstrated bactericidal
effects and there was at least a 5 log10 reduction in
bacterial colony counts after 48 h, compared with either drug alone.
BALB/c mice infected with 2.1-2.6 x 107 cfu
of Ab-153 were treated with 20 mg/kg meropenem every 8 h, 40 mg/kg sulbactam
every 8 h or both in combination. The survival rate of mice in the
combination group was significantly higher than that in the meropenem-treated
or sulbactam-treated group (87% versus 35%, P = 0.0004; 87% versus 30%, P = 0.0002). Conclusions: Meropenem in conjunction with sulbactam
can exhibit more potent antimicrobial activity against Ab-153 than
meropenem or sulbactam alone.
Keywords: synergy, combination therapy, time-kill
curves
In vitro and in vivo activity
of meropenem and sulbactam against a multidrug-resistant Acinetobacter
baumannii strain
2 Department of Internal Medicine, National
Cheng Kung University Hospital, Tainan, Taiwan
3 Department of Medicine, Chi Mei Medical Center;
4 Department of Medicine, National
Cheng Kung University Medical College;
5 Department of Medical Technology,
National Cheng Kung University Medical College;
6 Department of Medical Research, Chi Mei Medical Center;
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