|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|5667135||1407848||2017||3 صفحه PDF||ندارد||دانلود کنید|
â¢In vitro synergistic activity of ceftazidimeâavibactam (CAZâAVI) in combination with different antimicrobials was evaluated against KPC-producing K. pneumoniae (KPC-Kp).â¢CAZâAVI in combination with meropenem and imipenem was synergistic against both CAZâAVI -susceptible and -resistant KPC-Kp clinical isolates.â¢CAZâAVI restored meropenem and imipenem susceptibility against CAZâAVI -susceptible KPC-3 producers.â¢Combination of CAZâAVI with imipenem exerted higher susceptible breakpoint indices (SBPIs) against CAZâAVI -susceptible and -resistant KPC-Kp isolates.
ObjectivesCombination therapy has been recommended when using ceftazidimeâavibactam (CAZâAVI) for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp), but the optimal combination is unknown. Six common antimicrobial agents (ertapenem, imipenem, meropenem, gentamicin, tigecycline, and ciprofloxacin) were evaluated for synergy with the recently approved cephalosporinâÎ²-lactamase inhibitor combination CAZâAVI in this study.MethodsDifferent antimicrobial combinations were tested against 13 KPC-Kp, including CAZâAVI-susceptible (nÂ =Â 11) and resistant (nÂ =Â 2) clinical isolates. In vitro interactions of CAZâAVI with different antimicrobials were tested using the gradient synergy test. Changes in the minimum inhibitory concentration (MIC) value were interpreted using the fractional inhibitory concentration (FIC) index and susceptible breakpoint index (SBPI).ResultsThe combination of CAZâAVI with gentamicin or ciprofloxacin displayed no synergism against any of the KPC-Kp isolates, whereas synergistic activity was observed with imipenem and meropenem against all KPC-Kp isolates. Notably, CAZâAVI reduced MICs for meropenem and imipenem below the resistance breakpoints against all strains. The SBPI analysis showed that CAZâAVI in combination with imipenem achieved higher SBPI values than other CAZâAVI-based combinations.ConclusionsThese data suggest that combinations of CAZâAVI with imipenem may be considered a useful therapeutic option for the treatment of KPC-Kp infections.
Journal: International Journal of Infectious Diseases - Volume 65, December 2017, Pages 1-3