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Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria

Kombinationswirkung von SCE-2787 und Cefepime mit Aminoglykosiden auf gramnegative Erreger nosokomialer Infektionen

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Summary

Thein vitro activity of cefepime and SCE-2787, two new parenteral cephalosporins, and the combination effect with tobramycin and gentamicin against nosocomial gram-negative rods was studied using checker-board agar dilution technique. Cefepime showed excellentin-vitro activity againstKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris (MIC90 0.03–0.125 mg/l) and good to moderate activity againstAcinetobacter anitratus, Pseudomonas aeruginosa andPseudomonas cepacia (MIC90 4–16 mg/l). SCE-2787 had an excellent activity againstCitrobacter spp. (MIC90 0.125 mg/l) and a very good activity againstA. anitratus, P. aeruginosa andP. vulgaris (MIC90 1–2 mg/l).Pseudomonas maltophilia was not inhibited at therapeutically achievable concentrations (MIC90 64 mg/l). On average, 14–28% of the strains were inhibited by synergistic SCE-2787 aminoglycoside-combinations, whereas only 8.6% were inhibited by a synergistic effect of the combination with cefepime and gentamicin. No antagonism occurred with any of the combinations.

Zusammenfassung

Mittels der Checker-board-Agar-Dilutionstechnik wurden Cefepime und SCE-2787, zwei neue parenterale Cephalosporine sowie die Kombinationswirkung dieser Substanzen mit den Aminoglykosiden Tobramycin und Gentamicin gegen klinisch wichtige gramnegative Erreger untersucht. Cefepim zeigte eine ausgezeichneteIn-vitro-Wirksamkeit gegenüberKlebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens andProteus vulgaris, wobei die MHK90-Werte zwischen 0,03 und 0,125 mg/l lagen; eine gute bis mäßige Aktivität zeigte die Substanz gegenAcinetobacter anitratus, Pseudomonas aeruginosa undPseudomonas cepacia (MHK90-Werte zwischen 4 und 16 mg/l). SCE-2787 wies eine ausgezeichnete Aktivität gegenCitrobacter spp. (MHK90 0,125 mg/l) und eine sehr gute Aktivität gegenA. anitratus, P. aeruginosa undP. vulgaris auf (MHK90-Werte 1–2 mg/l),Pseudomonas maltophilia wurde allerdings von therapeutisch erreichbaren Konzentrationen nicht gehemmt (MHK90 64 mg/l). Bei 14–28% der Stämme wurde ein synergistischer Effekt der SCE-2787-Aminoglycosid-Kombination und in 8,6% der Stämme eine synergistische Wirkung der Cefepim-Gentamicin-Kombination beobachtet. Eine antagonistische Wirkung konnte bei keiner der untersuchten Kombinationen festgestellt werden.

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  1. Klinikhygiene, Universitätsklinikum, Hugstetter Str. 55, W-7800, Freiburg, Germany

    J. Hübner, D. Hartung,  A. Kropec &  F. D. Daschner

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  1. J. Hübner
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  2. D. Hartung
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  3. A. Kropec
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  4. F. D. Daschner
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Hübner, J., Hartung, D., Kropec, A. et al. Combination effect of SCE-2787 and cefepime with aminoglycosides on nosocomial gram-negative bacteria. Infection 19, 186–189 (1991). https://doi.org/10.1007/BF01643250

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