JAC Advance Access published online on February 8, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl512
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In vitro pharmacodynamics of colistin against Acinetobacter baumannii clinical isolates
1 Facility for Anti-infective Drug Development and Innovation, Victorian College of Pharmacy, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia 2 Department of Microbiology and Infectious Diseases Unit, Alfred Hospital, Australia
Received 31 July 2006; returned 6 September 2006; accepted 20 November 2006
* Corresponding author. Tel: + 61-3-9903-9702; Fax: + 61-3-9903-9629; E-mail: Jian.Li{at}vcp.monash.edu.au
BACKGROUND: Colistin is being increasingly used for treatment of infections caused by multidrug-resistant Gram-negative bacteria, including Acinetobacter baumannii.
METHODS: The in vitro pharmacodynamic properties of colistin (sulphate) were investigated by studying the time–kill kinetics and the post-antibiotic effect (PAE) against multidrug-resistant, including colistin heteroresistant, A. baumannii. Time–kill was studied with four multidrug-resistant clinical isolates at concentrations ranging from 0.5 to 64 x MIC. The PAE was examined after 20 min exposure with five clinical isolates, including the four in the time–kill study, plus ATCC 19606.
RESULTS: Colistin showed extremely rapid killing in a concentration-dependent manner; but re-growth was observed as early as 3 h and substantial re-growth at 24 h even at concentrations up to 32 x MIC or 64 x MIC for some isolates. Colistin exhibited modest PAE of 1.0, 2.3 and 3.5 h at 16, 32 and 64 x MIC, respectively, against ATCC 19606. Surprisingly, negative PAE (range: –0.8 to –8.15 h) was observed for all of the five clinical isolates.
CONCLUSIONS: These findings suggest that monotherapy with colistin methanesulphonate, the parenteral form of colistin, and long dosage intervals (e.g. 24 h) may be problematic for treatment of infections caused by colistin heteroresistant A. baumannii.
Key Words: killing kinetics , heteroresistance , post-antibiotic effect
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Plachouras, M. Karvanen, L. E. Friberg, E. Papadomichelakis, A. Antoniadou, I. Tsangaris, I. Karaiskos, G. Poulakou, F. Kontopidou, A. Armaganidis, et al. Population Pharmacokinetic Analysis of Colistin Methanesulfonate and Colistin after Intravenous Administration in Critically Ill Patients with Infections Caused by Gram-Negative Bacteria Antimicrob. Agents Chemother., August 1, 2009; 53(8): 3430 - 3436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Poudyal, B. P. Howden, J. M. Bell, W. Gao, R. J. Owen, J. D. Turnidge, R. L. Nation, and J. Li In vitro pharmacodynamics of colistin against multidrug-resistant Klebsiella pneumoniae J. Antimicrob. Chemother., December 1, 2008; 62(6): 1311 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Cao, F. E. A. Ali, F. Chiu, A. P. Zavascki, R. L. Nation, and J. Li Development and validation of a reversed-phase high-performance liquid chromatography assay for polymyxin B in human plasma J. Antimicrob. Chemother., November 1, 2008; 62(5): 1009 - 1014. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A Pastewski, P. Caruso, A. R Parris, R. Dizon, R. Kopec, S. Sharma, S. Mayer, M. Ghitan, and E. K Chapnick Parenteral Polymyxin B Use in Patients with Multidrug-Resistant Gram-Negative Bacteremia and Urinary Tract Infections: A Retrospective Case Series Ann. Pharmacother., September 1, 2008; 42(9): 1177 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Landman, C. Georgescu, D. A. Martin, and J. Quale Polymyxins Revisited Clin. Microbiol. Rev., July 1, 2008; 21(3): 449 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Y. Peleg, H. Seifert, and D. L. Paterson Acinetobacter baumannii: Emergence of a Successful Pathogen Clin. Microbiol. Rev., July 1, 2008; 21(3): 538 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Burgess and R. P. Rapp Bugs versus drugs: Addressing the pharmacist's challenge Am. J. Health Syst. Pharm., May 1, 2008; 65(9_Supplement_2): S4 - S15. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. S. Munoz-Price and R. A. Weinstein Acinetobacter Infection N. Engl. J. Med., March 20, 2008; 358(12): 1271 - 1281. [Full Text] [PDF]
|
|
|
|
|
|
J. Y. Song and H. J. Cheong Comment on: Acinetobacter spp. and time-kill studies J. Antimicrob. Chemother., February 1, 2008; 61(2): 465 - 466. [Full Text] [PDF]
|
|
|
|
|
|
T. Y. Tan and L. S. Y. Ng Comment on: Acinetobacter spp. and time-kill studies J. Antimicrob. Chemother., February 1, 2008; 61(2): 464 - 465. [Full Text] [PDF]
|
|
|
|
|
|
A. P. Zavascki, L. Z. Goldani, J. Li, and R. L. Nation Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review J. Antimicrob. Chemother., December 1, 2007; 60(6): 1206 - 1215. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Hawley, C. K. Murray, and J. H. Jorgensen Development of Colistin-Dependent Acinetobacter baumannii-Acinetobacter calcoaceticus Complex Antimicrob. Agents Chemother., December 1, 2007; 51(12): 4529 - 4530. [Full Text] [PDF]
|
|
|
|
|
|
T. Y. Tan, L. S. Y. Ng, E. Tan, and G. Huang In vitro effect of minocycline and colistin combinations on imipenem-resistant Acinetobacter baumannii clinical isolates J. Antimicrob. Chemother., August 1, 2007; 60(2): 421 - 423. [Abstract] [Full Text] [PDF]
|
|