Decreased susceptibility of penicillin-resistant pnenmococci to twenty-four βlactam antibiotics

Liñares, Josefina; Alonso, Teresa; Pérez, José Luís; Ayats, Josefina; Domı́nguez, M.A.; Pallarés, Román; Martin, R. Russell

doi:10.1093/jac/30.3.279

Cited by 154 publications

(73 citation statements)

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“…Results of oral cephalosporins mirrored those obtained in previous MIC testing studies (7,15,19,22,27,28,30), with cefuroxime, cefdinir, and cefpodoxime yielding the greatest activity. Cefpodoxime, although yielding relatively low bactericidal levels, was sometimes bactericidal only at Ն2 dilutions above the bacteriostatic level.…”

Section: Discussionsupporting

confidence: 73%

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Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci

Pankuch

Visalli

Jacobs

et al. 1995

Antimicrob Agents Chemother

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This study examined bacteriostatic and bactericidal activities of oral and parenteral antibiotics for penicillin-susceptible and intermediately and fully penicillin-resistant pneumococci. ␤-Lactamase inhibitors did not affect ␤-lactam results. The activities of ampicillin, amoxicillin ؎ clavulanate, WY-49605, cefuroxime, cefpodoxime, cefdinir, cefixime, and cefaclor against two penicillin-susceptible, two intermediately penicillin-resistant, and two fully penicillin-resistant pneumococcal strains were tested. For all three groups, bacteriostatic values of amoxicillin and WY-49605 were lower than were those of other ␤-lactams tested. Of the cephalosporins, cefdinir, cefuroxime, and cefpodoxime yielded the lowest bacteriostatic values. All ␤-lactams were bactericidal (reduced original counts by >3 log 10 CFU/ml) at 1 dilution above bacteriostatic values, except for cefpodoxime (bactericidal at 2 dilutions above bacteriostatic values for one susceptible strain and one intermediately resistant strain), cefuroxime (bactericidal at 2 dilutions above bacteriostatic values for one intermediately resistant strain), and ampicillin (bactericidal at 2 dilutions above bacteriostatic values for one intermediately resistant strain). The activities of piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillinclavulanate, ampicillin, ampicillin-sulbactam, ceftriaxone, ceftazidime, and ciprofloxacin against four penicillin-susceptible, two intermediately penicillin-resistant, and four fully penicillin-resistant pneumococcal strains were evaluated. Bacteriostatic values of piperacillin, ampicillin, and ceftriaxone for all groups were lower than were those of ticarcillin and ceftazidime. Bacteriostatic values of ciprofloxacin were unaffected by penicillin susceptibility. All ␤-lactams were bactericidal at 1 dilution above the bacteriostatic value, except for piperacillin (bactericidal at 2 dilutions above the bacteriostatic value for one intermediately resistant strain), ticarcillin (bactericidal at 2 dilutions above the bacteriostatic value for one susceptible strain and one resistant strain), ampicillin (bactericidal at 2 dilutions above the bacteriostatic value for two resistant strains), ceftriaxone (bactericidal at 2 dilutions above the bacteriostatic value for one resistant strain), and ceftazidime (bactericidal at 2 dilutions above the bacteriostatic value for one susceptible strain).

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Section: Discussionsupporting

confidence: 73%

“…Previous studies have documented relatively high MICs of all groups of oral cephalosporins for these strains, with cefdinir, cefuroxime, and cefpodoxime yielding the lowest MICs for the group (7,15,19,22,27,28,30). Amoxicillin has MICs lower than those of penicillin G, ampicillin, and oral cephalosporins for these strains (7,22,27).…”

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confidence: 88%

Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci

Pankuch

Visalli

Jacobs

et al. 1995

Antimicrob Agents Chemother

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“…44, 45 Although we did not perform MIC testing of second-generation cephalosporins in this study, these agents have MIC profiles more similar to that of penicillin than to those of third-generation cephalosporins. 46 Future studies of antibiotic-resistant pneumococcal pneumonia need to define better the particulars of antibiotic administration so that treatment failure can be further evaluated in the setting of elevated MICs.…”

Section: Discussionmentioning

confidence: 99%

Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997

Feikin

Schuchat²,

Kolczak³

et al. 2000

Am J Public Health

516

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OBJECTIVES: This study examined epidemiologic factors affecting mortality from pneumococcal pneumonia in 1995 through 1997. METHODS: Persons residing in a surveillance area who had community-acquired pneumonia requiring hospitalization and Streptococcus pneumoniae isolated from a sterile site were included in the analysis. Factors affecting mortality were evaluated in univariate and multivariate analyses. The number of deaths from pneumococcal pneumonia requiring hospitalization in the United States in 1996 was estimated. RESULTS: Of 5837 cases, 12% were fatal. Increased mortality was associated with older age, underlying disease. Asian race, and residence in Toronto/Peel, Ontario. When these factors were controlled for, increased mortality was not associated with resistance to penicillin or cefotaxime. However, when deaths during the first 4 hospital days were excluded, mortality was significantly associated with penicillin minimum inhibitory concentrations of 4.0 or higher and cefotaxime minimum inhibitory concentrations of 2.0 or higher. In 1996, about 7000 to 12,500 deaths occurred in the United States from pneumococcal pneumonia requiring hospitalization. CONCLUSIONS: Older age and underlying disease remain the most important factors influencing death from pneumococcal pneumonia. Mortality was not elevated in most infections with beta-lactam-resistant pneumococci.

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“…Although this organism was originally exquisitely susceptible to penicillin, the past two decades, and in particular the fast few years, have witnessed an alarming increase in the number of strains resistant to penicillin as well as other antimicrobial agents all over the world (2,14,18,19).…”

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confidence: 99%

Study of comparative antipneumococcal activities of penicillin G, RP 59500, erythromycin, sparfloxacin, ciprofloxacin, and vancomycin by using time-kill methodology

Pankuch

Jacobs

Appelbaum

1994

Antimicrob Agents Chemother

125

161

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Time-kill studies were used to examine the in vitro activities of penicillin G, RP 59500, erythromycin, ciprofloxacin, sparfloxacin, and vancomycin against 10 pneumococci expressing various degrees of susceptibility to penicillin and erythromycin. RP 59500 MICs for all strains were 0.5 to 2.0 Fg/ml, while erythromycin MICs were 0.008 to 0.06 ,ug/ml for erythromycin-susceptible strains and 32.0 to 64.0 ,g/ml for erythromycinresistant strains. Strains were more susceptible to sparfloxacin (0.125 to 0.5 ,ug/ml) than to ciprofloxacin (0.5 to 4.0 ,ug/ml), and all were inhibited by vancomycin at MICs of 0.25 to 0.5 ,ug/ml. Time-kill studies showed that antibiotic concentrations greater than the MIC were bactericidal for each strain, with the following exceptions. Erythromycin was bactericidal for one penicillin-resistant strain at 6 h, with regrowth after 12 and 24 h. Three penicillin-susceptible strains were bacteriostatically inhibited by erythromycin at concentrations greater than or equal to the MIC by 6 h. One penicillin-susceptible strain (penicillin MIC, 0.06 ,Ig/ml) was bacteriostatically inhibited by penicillin G at 24 h at the MIC or at one-half the MIC; a bactericidal effect was found only with penicillin G at concentrations of .0.25 ,ug/ml. At 10 min after inoculation a 1-to 3-log1o-unit reduction (90 to 99.9%6) in the original inoculum was seen for 6 of 10 strains with RP 59500 at concentrations greater than or equal to the MIC. This eflect was not found with any of the other compounds tested. A bactericidal effect was found at .6 h with RP 59500 at concentrations of one-half to one-quarter the MIC in 7 of 10 strains, and a bacteriostatic effect was found in 3 of 10 strains, with regrowth at 24 h. One penicillin-resistant strain was examined by the time-kill methodology at 0, 1, 2, and 3 h. RP 59500 at a concentration equal to the MIC was bactericidal within 1 h, and at a concentration of one-half the MIC it was bactericidal within 3 h. This phenomenon was not seen with the other antimicrobial agents tested. Regrowth of strains at ciprofloxacin concentrations equal to the MIC or at one-half to one-quarter the MIC was found. For sparfloxacin, three of four penicillin-susceptible strains and two of four penicillin-resistant strains were bacteriostatically inhibited by 6 h. Bactericidal effects were found at 6, 12, and 24 h with both intermediate-resistant, one penicillinsusceptible, and two penicillin-resistant strains. Complete killing was observed with vancomycin at concentrations greater than the MIC. Of the new compounds tested, RP 59500 and sparfloxacin show promise for the treatment of infections caused by penicillin-susceptible and -resistant pneumococci. The clinical significance of rapid killing by RP 59500 remains to be determined.Streptococcuspneumoniae continues to be a significant cause of morbidity and mortality in humans and is the leading cause of bacterial pneumonia as well as an important cause of otitis media and meningitis. Although this organism was originally exquisitely susceptible to...

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Decreased susceptibility of penicillin-resistant pnenmococci to twenty-four βlactam antibiotics

Cited by 154 publications

References 0 publications

Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci

Activities of oral and parenteral agents against penicillin-susceptible and -resistant pneumococci

Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997

Study of comparative antipneumococcal activities of penicillin G, RP 59500, erythromycin, sparfloxacin, ciprofloxacin, and vancomycin by using time-kill methodology

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