A Prospective Study on the Efficiency of Ciprofloxacin in Combination with Chloramphenicol against Multiple Antibiotics Resistant <i>Klebsiella pneumonia</i>

Abstract

Pneumonia is the single largest infectious cause of death in children worldwide and also a form of an acute respiratory infection that affects the lung. The purpose of the study was to develop a new approach to treat antibiotic-resistant K. pneumoniae infection. This study aimed in quest of a drug to combine with ciprofloxacin, a broad spectrum antibiotic frequently used to treat lung infections. Methodology: A total of 23 lung infection bacterial samples were collected and studied against 14 antibiotics of different classes. The disk diffusion method was performed to determine synergy screening, MIC value, and qualitative toxicity analysis of ciprofloxacin and chloramphenicol combination. Results: After primary screening of antibiotic susceptibility, they were categorized into multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan drug-resistant (PDR) pathogens where 9 isolates were MDR, 5 were XDR and 3 isolates were PDR. Furthermore, they were trialed in combination ciprofloxacin along with other 7 drugs in disk diffusion to explore the synergistic effect. The combination of ciprofloxacin and moxifloxacin, ciprofloxacin and chloramphenicol were found to be synergic. Then the MIC test was done for the combination ciprofloxacin and chloramphenicol. When the MIC result was generated, the MIC of the respective combination was analyzed. Furthermore, the fractional inhibitory concentration (FIC) was calculated and in accordance with the results of the FIC index, ciprofloxacin-chloramphenicol combination has shown value 0.4510 which revealed a synergistic effect against multi-drug resistant Klebsiella pneumoniae. Conclusion: Given these points,

Detection of Virulence Factors and Antibiotic Resistance among Klebsiella pneumoniae Isolates from Iran

“…In a study done by Shadkam et al (Iran) [ 25 ], 67% of K. pneumoniae were MDR and 11% of them were XDR, but no PDR isolate was reported. In a research performed by Ahmed et al (Bangladesh) [ 26 ], 39.1% of K. pneumoniae were MDR, 21.7% of them were XDR, and 3.75% were PDR. In a research performed by El-Domany et al (Egypt) [ 8 ], 42.5% of K. pneumoniae were MDR, 35% of them were XDR, and 5% were PDR.…”

“…These differences are due to the high prevalence of bla OXA-48 in Turkey and European countries. Also, the prevalence of bla NDM among K. pneumoniae isolates reported 5% in a study performed by Ahmed et al in 2020, Bangladesh [ 26 ]; 10% in a study performed by Moghadampour et al in 2018, Iran; and 23.3% in a study performed by Rad et al in 2020, Iran [ 18 ].…”