Characterization of bactericidal activity of clindamycin against Bacteroides fragilis via kill curve methods

Klepser, Michael E.; Banevicius, Mary Anné; Quintiliani, Richard; Nightingale, C H

doi:10.1128/aac.40.8.1941

Cited by 17 publications

(12 citation statements)

References 21 publications

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“…Metronidazole, cefoxitin and imipenem exhibited concentration‐ and exposure‐time‐dependent killing, whereas only static activity was observed after chloramphenicol and clindamycin. In contrast, Klepser et al recently demonstrated bactericidal activity of ˜0.2–1.0 log 10 CFU/mL over a 4‐h period, dependent on exposure time but not concentration [6]. The discrepancy between these observations and ours of no bactericidal activity may be explained by strain difference and different exposure media.…”

Section: Discussioncontrasting

confidence: 74%

Postantibiotic effects with Bacteroides fragilis determined by viable counts and CO2 generation

Valdimarsdóttir

Erlendsdóttir

Guðmundsson

1997

Clinical Microbiology and Infection

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OBJECTIVE: To study the postantibiotic effect (PAE) for Bacteroides fragilis after exposure to common anaerobic antimicrobials with two different methods, by viable counting and by measuring CO2 generation in a BACTEC(R) blood culture system. METHODS: Four strains of B. fragilis were exposed for 1, 2 and 4 h to cefoxitin, chloramphenicol, clindamycin, imipenem or metronidazole at concentrations from 1 to 16 x MIC. The drugs were removed by dilution into BACTEC 7A(R) vials and growth determined with viability counts and CO2 production. RESULTS: The durations of the PAEs determined by the two methods correlated well (r=0.913, p<0.005). PAEs of up to 4-5 h were induced by imipenem and metronidazole with achievable concentrations and exposure durations. Chloramphenicol induced short or no PAEs, but cefoxitin and clindamycin induced PAEs up to 2 h with high AUC values. The imipenem PAEs and the short cefoxitin and clindamycin PAEs were dependent on AUC. CONCLUSIONS: Significant PAEs against B. fragilis were induced by imipenem and metronidazole. Determining PAE by measuring CO2 production is an accurate and less time-consuming alternative to the conventional method of viable counts.

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Section: Discussioncontrasting

confidence: 74%

Postantibiotic effects with Bacteroides fragilis determined by viable counts and CO2 generation

Valdimarsdóttir

Erlendsdóttir

Guðmundsson

1997

Clinical Microbiology and Infection

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“…40 It is not active against multiresistant MRSA (mrMRSA), but MSSA and most strains of non-multiresistant MRSA (nmrMRSA) are generally clindamycin susceptible. [30][31][32] Clindamycin is essentially bacteriostatic, displays time-dependent activity at concentrations >4 times the MIC, 41 and has a modest in vitro postantibiotic effect against S. aureus. 42 Like the macrolides, it is bacteriostatic and therefore should be avoided as the sole treatment for endocarditis.…”

Section: Lincosamidesmentioning

confidence: 99%

Antibiotics currently used in the treatment of infections caused by Staphylococcus aureus

Rayner¹,

Munckhof²

2005

Internal Medicine Journal

168

113

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Staphylococcal infections are a common and significant clinical problem in medical practice. Most strains of Staphylococcus aureus are now resistant to penicillin, and methicillin-resistant strains of S. aureus (MRSA) are common in hospitals and are emerging in the community. Penicillinase-resistant penicillins (flucloxacillin, dicloxacillin) remain the antibiotics of choice for the management of serious methicillin-susceptible S. aureus (MSSA) infections, but first generation cephalosporins (cefazolin, cephalothin and cephalexin), clindamycin, lincomycin and erythromycin have important therapeutic roles in less serious MSSA infections such as skin and soft tissue infections or in patients with penicillin hypersensitivity, although cephalosporins are contra-indicated in patients with immediate penicillin hypersensitivity (urticaria, angioedema, bronchospasm or anaphylaxis). All serious MRSA infections should be treated with parenteral vancomycin or, if the patient is vancomycin allergic, teicoplanin. Nosocomial strains of MRSA are typically multi-resistant (mrMRSA), and mrMRSA strains must always be treated with a combination of two oral antimicrobials, typically rifampicin and fusidic acid, because resistance develops rapidly if they are used as single agents. Most community-acquired strains of MRSA in Australia and New Zealand are non multiresistant (nmMRSA), and lincosamides (clindamycin, lincomycin) or cotrimoxazole are the antibiotics of choice for less serious nmMRSA infections such as skin and soft tissue infections. New antibiotics such as linezolid and quinupristin/dalfopristin have good antistaphylococcal activity but are very expensive and should be reserved for patients who fail on or are intolerant of conventional therapy or who have highly resistant strains such as hVISA (heterogenous vancomycin-intermediate S aureus).

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“…therapy viable therapeutic options. However, despite our wealth of clinical experience with clindamycin, it is only recently that the pharmacodynamic properties of this agent have been adequately described (7,8,14).…”

Section: Discussionmentioning

confidence: 99%

Bactericidal activity of low-dose clindamycin administered at 8- and 12-hour intervals against Staphylococcus aureus, Streptococcus pneumoniae, and Bacteroides fragilis

Klepser

Nicolau

Quintiliani

et al. 1997

Antimicrob Agents Chemother

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Twelve volunteers received 300 mg of clindamycin intravenously (i.v.) or orally (p.o.) administered every 8 h (q8h) or q12h by random assignment over four study periods. Serum bactericidal titers were determined for each regimen against two isolates each of Staphylococcus aureus, Streptococcus pneumoniae (one penicillin-sensitive isolate and one penicillin-resistant isolate), and Bacteroides fragilis. The duration of measurable bactericidal activity over the dosing interval (expressed as a percentage of the dosing interval) was determined for each isolate. No significant differences in the duration of activity were observed between i.v. and p.o. regimens dosed according to the same interval (P > 0.05). All regimens provided bactericidal activity against S. pneumoniae for 100% of their respective dosing intervals. Against B. fragilis, bactericidal activity was observed for greater than 80% of the dosing interval for each of the regimens. Although a statistically significant difference favoring the q8h i.v. regimen (P < 0.05) was detected, this difference is not believed to be clinically significant. The q8h and q12h regimens provided measurable bactericidal activity against S. aureus for greater than 85 and 50% of the dosing intervals, respectively (P < 0.001). Clindamycin dosed at 300 mg i.v. or p.o., q8h or q12h, provides adequate coverage against S. aureus, S. pneumoniae, and B. fragilis.

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Characterization of bactericidal activity of clindamycin against Bacteroides fragilis via kill curve methods

Cited by 17 publications

References 21 publications

Postantibiotic effects with Bacteroides fragilis determined by viable counts and CO2 generation

Postantibiotic effects with Bacteroides fragilis determined by viable counts and CO2 generation

Antibiotics currently used in the treatment of infections caused by Staphylococcus aureus

Bactericidal activity of low-dose clindamycin administered at 8- and 12-hour intervals against Staphylococcus aureus, Streptococcus pneumoniae, and Bacteroides fragilis

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