Combined action of penicillin with streptomycin or chloromycetin on enterococci in vitro

Jawetz, Ernest; Gunnison, J. B.; Coleman, Virginia R.

doi:10.1016/0002-9343(50)90256-7

Cited by 30 publications

(38 citation statements)

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“…Conversely, cells grown in media that permitted less rapid penicillin lysis were less susceptible to spontaneous lysis (Table III). Our studies have demonstrated more rapid and extensive penicillin lysis and killing of S. faecalis than those of most previous investigators (3)(4)(5)(35)(36). We believe that the reasons for these differences include (a) strain variation and (b) differences in the specific testing conditions used.…”

Section: Discussionmentioning

confidence: 46%

“…The idea that inhibition of cell wall synthesis and killing induced by penicillin may have different mechanisms is supported by the occurrence of enterococci and other bacteria that are much more resistant to the lethal effect of penicillin than they are to its growth inhibitory effect. The resistance of enterococci to penicillin killing in vitro has been demonstrated by time-kill studies (3)(4)(5) and by the high ratio of the minimal bactericidal concentration (MBC)1 to the minimal inhibitory concentration (MIC) of penicillin for these strains (4,(6)(7)(8)(9)(10)(11). The clinical relevance of these in vitro results is supported by the observation that enterococcal endocarditis is resistant to treatment with penicillin alone (12,13), in contrast to endocarditis caused by most other streptococci (14).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antibiotic-induced lysis of enterococci.

Storch¹,

Krogstad²

1981

J. Clin. Invest.

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Section: Discussionmentioning

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Antibiotic-induced lysis of enterococci.

Storch¹,

Krogstad²

1981

J. Clin. Invest.

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“…[15][16][17]20 Since the middle of the last century, in vitro studies, animal studies, and many patient reports have demonstrated a synergistic effect with better cure rates when a β-lactam antibiotic is combined with an aminoglycoside. [29][30][31][32][33][34] Therefore, this combination has been widely used worldwide, and with 4 to 6 weeks of treatment, 3-month cure rates of ≈80% have been achieved. 1,2,7,12,35,36 Interestingly, in 2007, Gavaldà and colleagues 37 presented an alternative treatment with a 6-week combination of ampicillin and ceftriaxone in enterococcal IE.…”

Section: Discussionmentioning

confidence: 99%

Enterococcus faecalis Infective Endocarditis

et al. 2013

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Background-Because of the nephrotoxic effects of aminoglycosides, the Danish guidelines on infective endocarditis were changed in January 2007, reducing gentamicin treatment in enterococcal infective endocarditis from 4 to 6 weeks to only 2 weeks. In this pilot study, we compare outcomes in patients with Enterococcus faecalis infective endocarditis treated in the years before and after endorsement of these new recommendations. Methods and Results-A total of 84 consecutive patients admitted with definite left-sided E faecalis endocarditis in the period of 2002 to 2011 were enrolled. Forty-one patients were treated before and 43 patients were treated after January 1, 2007. There were no significant differences in baseline characteristics. At hospitalization, the 2 groups had similar estimated glomerular filtration rates of 66 and 75 mL/min (P=0.22). Patients treated before January 2007 received gentamicin for a significantly longer period (28 versus 14 days; P<0.001). The primary outcome, 1-year event-free survival, did not differ: 66% versus 69%, respectively (P=0.75). At discharge, the patients treated before 2007 had a lower estimated glomerular filtration rate (45 versus 66 mL/min; P=0.008) and a significantly greater decrease in estimated glomerular filtration rate (median, 11 versus 1 mL/min; P=0.009) compared with those treated after 2007. Conclusions-Our present pilot study suggests that the recommended 2-week treatment with gentamicin seems adequate and preferable in treating non-high-level aminoglycoside-resistant E faecalis infective endocarditis. The longer duration of gentamicin treatment is associated with worse renal function. Although the certainty of the clinical outcomes is limited by the sample size, outcomes appear to be no worse with the shorter treatment duration. Randomized, controlled studies are warranted to substantiate these results. Dahl et al Gentamicin in Enterococcal Endocarditis 1811 Methods DatabaseData from consecutive patients diagnosed with IE in 2 tertiary heart centers in Copenhagen, Denmark, were prospectively collected beginning on October 1, 2002. These 2 highly specialized university hospitals serve as the only referral centers for IE patients in the eastern part of Denmark and cover a catchment area of 2.4 million people. The diagnosis of IE was based on clinical, microbiological, and echocardiographic findings. Patients were enrolled in the database if they met the revised Duke criteria 25 of definite or possible IE. Patients with possible IE were included only if they received treatment as patients with definite IE. All data were collected with a standardized case report form with >250 variables, including demographics; medical history; physical examination findings; results of blood tests, including blood cultures; ECG; antibiotic use; surgical treatment; and findings of both transthoracic and transesophageal echocardiography. Duration of symptoms was defined as the time from the appearance of the first symptoms of IE (reported by the patient or his or her close famil...

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“…ENHANCEMENT of the bactericidal activity of benzylpenicillin against enterococci by streptomycin is one of the earliest and best known examples of antibiotic synergism (Jawetz, Gunnison and Coleman, 1950). Enterococci are moderately sensitive in vitro to benzylpenicillin, which may also exert marked bactericidal activity though it generally fails to bring about complete sterilisation of cultures of these organisms.…”

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confidence: 99%