In vitro Interaction between Ofloxacin and Cefotaxime against Gram-Positive and Gram-Negative Bacteria Involved in Serious Infections

Gimeno, Concepción; Borja, Javier; Navarro, David; Valdés, L.; García-Barbal, J; García‐de‐Lomas, Juan

doi:10.1159/000007098

Cited by 14 publications

(8 citation statements)

References 13 publications

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“…Conflicting data exist on the synergy of fluoroquinolones with ß-lactams, varying from synergy to indifference depending on the antibiotic tested [17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Activity of Levofloxacin and Ciprofloxacin in Combination with Cefepime, Ceftazidime, Imipenem, Piperacillin-Tazobactam and Amikacin against Different Pseudomonas aeruginosa Phenotypes and Acinetobacter spp.

et al. 2004

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Background: Combination therapy is used to widen the antimicrobial spectrum, minimize toxicity and prevent the emergence of resistant mutants. Methods: Synergy between levofloxacin or ciprofloxacin and ceftazidime, cefepime, imipenem, piperacillin-tazobactam and amikacin was evaluated by checkerboard assay with 55 strains and by time-kill curves with 8 strains of Pseudomonasaeruginosa and Acinetobacter spp. Results: In the checkerboard assay, synergy and additivity were the most frequent effects observed among all the combinations against P. aeruginosa and Acinetobacter spp., with no significant differences between the two fluoroquinolones. No antagonism was observed. In the time-kill curves, synergy was evidenced against all the tested strains, at least for one combination at one of the time points considered. Levofloxacin and ciprofloxacin combined with ceftazidime, as well as levofloxacin plus amikacin, were synergistic for all the strains tested. Conclusion: Combinations of fluoroquinolones with β-lactams or amikacin show an enhanced activity against P. aeruginosa and Acinetobacter spp.

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“…Conflicting data exist on the synergy of fluoroquinolones with ß-lactams, varying from synergy to indifference depending on the antibiotic tested [17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Activity of Levofloxacin and Ciprofloxacin in Combination with Cefepime, Ceftazidime, Imipenem, Piperacillin-Tazobactam and Amikacin against Different Pseudomonas aeruginosa Phenotypes and Acinetobacter spp.

et al. 2004

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“…Antimicrobial synergy with increased bacterial clearance appears to be best established for β-lactam/aminoglycoside combinations 227 - 230 . However, similar data on synergistic activity has emerged for combinations of a β-lactam and fluoroquinolone 231 - 237 . There is even some data suggesting additive effects 238 or even potential synergism 239 - 242 for β-lactam/macrolides combinations in certain circumstances.…”

Section: Combination Vs Monotherapymentioning

confidence: 99%

An alternate pathophysiologic paradigm of sepsis and septic shock

Kumar

2013

Virulence

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The advent of modern antimicrobial therapy following the discovery of penicillin during the 1940s yielded remarkable improvements in case fatality rate of serious infections including septic shock. Since then, pathogens have continuously evolved under selective antimicrobial pressure resulting in a lack of significant improvement in clinical effectiveness in the antimicrobial therapy of septic shock despite ever more broad-spectrum and potent drugs. In addition, although substantial effort and money has been expended on the development novel non-antimicrobial therapies of sepsis in the past 30 years, clinical progress in this regard has been limited. This review explores the possibility that the current pathophysiologic paradigm of septic shock fails to appropriately consider the primacy of the microbial burden of infection as the primary driver of septic organ dysfunction. An alternate paradigm is offered that suggests that has substantial implications for optimizing antimicrobial therapy in septic shock. This model of disease progression suggests the key to significant improvement in the outcome of septic shock may lie, in great part, with improvements in delivery of existing antimicrobials and other anti-infectious strategies. Recognition of the role of delays in administration of antimicrobial therapy in the poor outcomes of septic shock is central to this effort. However, therapeutic strategies that improve the degree of antimicrobial cidality likely also have a crucial role.

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“…Although antimicrobial synergy appears to be best established for ␤-lactam-aminoglycoside combinations, similar data on synergistic activity have emerged for combinations of ␤-lactams and fluoroquinolones (14,50,77,96,99,132,168,183,189,205,252,253). In vitro synergy between ␤-lactams and fluoroquinolones against Gram-negative organisms has ranged from 17% to 82% (96,119,168).…”

Section: Synergymentioning

confidence: 99%

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

2012

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SUMMARY Combination antibiotic therapy for invasive infections with Gram-negative bacteria is employed in many health care facilities, especially for certain subgroups of patients, including those with neutropenia, those with infections caused by Pseudomonas aeruginosa , those with ventilator-associated pneumonia, and the severely ill. An argument can be made for empiric combination therapy, as we are witnessing a rise in infections caused by multidrug-resistant Gram-negative organisms. The wisdom of continued combination therapy after an organism is isolated and antimicrobial susceptibility data are known, however, is more controversial. The available evidence suggests that the greatest benefit of combination antibiotic therapy stems from the increased likelihood of choosing an effective agent during empiric therapy, rather than exploitation of in vitro synergy or the prevention of resistance during definitive treatment. In this review, we summarize the available data comparing monotherapy versus combination antimicrobial therapy for the treatment of infections with Gram-negative bacteria.

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In vitro Interaction between Ofloxacin and Cefotaxime against Gram-Positive and Gram-Negative Bacteria Involved in Serious Infections

Cited by 14 publications

References 13 publications

Activity of Levofloxacin and Ciprofloxacin in Combination with Cefepime, Ceftazidime, Imipenem, Piperacillin-Tazobactam and Amikacin against Different <i>Pseudomonas aeruginosa</i> Phenotypes and <i>Acinetobacter</i> spp.

Activity of Levofloxacin and Ciprofloxacin in Combination with Cefepime, Ceftazidime, Imipenem, Piperacillin-Tazobactam and Amikacin against Different <i>Pseudomonas aeruginosa</i> Phenotypes and <i>Acinetobacter</i> spp.

An alternate pathophysiologic paradigm of sepsis and septic shock

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

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