In vitro susceptibilities of Borrelia burgdorferi to five oral cephalosporins and ceftriaxone

Agger, William A.; Callister, Steven M.; Jobe, Dean A.

doi:10.1128/aac.36.8.1788

Cited by 51 publications

(31 citation statements)

References 18 publications

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“…Borrelia burgdorferi sensu stricto has been recovered, however, from cultures of EM lesions of patients treated with the narrow-spectrum cephalosporin cephalexin, an antibiotic which is inactive in vitro against B. burgdorferi sensu lato and ineffective clinically (4,226).…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Diagnosis of Lyme Borreliosis

et al. 2005

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A large amount of knowledge has been acquired since the original descriptions of Lyme borreliosis (LB) and of its causative agent, Borrelia burgdorferi sensu stricto. The complexity of the organism and the variations in the clinical manifestations of LB caused by the different B. burgdorferi sensu lato species were not then anticipated. Considerable improvement has been achieved in detection of B. burgdorferi sensu lato by culture, particularly of blood specimens during early stages of disease. Culturing plasma and increasing the volume of material cultured have accomplished this. Further improvements might be obtained if molecular methods are used for detection of growth in culture and if culture methods are automated. Unfortunately, culture is insensitive in extracutaneous manifestations of LB. PCR and culture have high sensitivity on skin samples of patients with EM whose diagnosis is based mostly on clinical recognition of the lesion. PCR on material obtained from extracutaneous sites is in general of low sensitivity, with the exception of synovial fluid. PCR on synovial fluid has shown a sensitivity of up to >90% (when using four different primer sets) in patients with untreated or partially treated Lyme arthritis, making it a helpful confirmatory test in these patients. Currently, the best use of PCR is for confirmation of the clinical diagnosis of suspected Lyme arthritis in patients who are IgG immunoblot positive. PCR should not be used as the sole laboratory modality to support a clinical diagnosis of extracutaneous LB. PCR positivity in seronegative patients suspected of having late manifestations of LB most likely represents a false-positive result. Because of difficulties in direct methods of detection, laboratory tests currently in use are mainly those detecting antibodies to B. burgdorferi sensu lato. Tests used to detect antibodies to B. burgdorferi sensu lato have evolved from the initial formats as more knowledge on the immunodominant antigens has been collected. The recommendation for two-tier testing was an attempt to standardize testing and improve specificity in the United States. First-tier assays using whole-cell sonicates of B. burgdorferi sensu lato need to be standardized in terms of antigen composition and detection threshold of specific immunoglobulin classes. The search for improved serologic tests has stimulated the development of recombinant protein antigens and the synthesis of specific peptides from immunodominant antigens. The use of these materials alone or in combination as the source of antigen in a single-tier immunoassay may someday replace the currently recommended two-tier testing strategy. Evaluation of these assays is currently being done, and there is evidence that certain of these antigens may be broadly cross-reactive with the B. burgdorferi sensu lato species causing LB in Europe

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Section: Laboratory Diagnosismentioning

confidence: 99%

Diagnosis of Lyme Borreliosis

et al. 2005

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“…Although many antibiotics have been used successfully in the treatment of Lyme disease, the full spectrum of antibiotic susceptibility of B. burgdorfien has not been fully defined. B. burgdorferi has been reported to be susceptible in vitro to a variety of antibiotics, including penicillin, amoxicillin, ceftriaxone, cefotaxime, cefuroxime, doxycycline, tetracycline, erythromycin, clarithromycin, and azithromycin (2,15,18,19,31). Oral doxycycline, amoxicillin and, to a lesser extent, erythromycin have been the antibiotics recommended most often for the treatment of the early stages of Lyme disease (11,27,32,36).…”

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In vitro activity of vancomycin against the spirochete Borrelia burgdorferi

Dever

Jorgensen

Barbour

1993

Antimicrob Agents Chemother

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Borrelia burgdorferi, a spirochete and the causative agent of Lyme disease, has been reported to be susceptible to a variety of antimicrobial agents. In this investigation, the action of vancomycin, a glycopeptide antibiotic not previously known to have activity against spirochetes, against borrelias was examined. The in vitro activity of vancomycin against a variety of strains ofB. burgdorferi and one strain ofBorrelia hermsii was determined by use of a microdilution MIC method (L. L. Dever, J. H. Jorgensen, and A. G. Barbour, J. Clin. Microbiol. 30:2692Microbiol. 30: -2697Microbiol. 30: , 1992. MICs ranged from 0.5 to 2 ,ug/ml. MICs of the glycopeptides ristocetin and teicoplanin and the lipopeptide daptomycin against strain B31 ofB. burgdorferi were all .8 ,ug/ml. Subsurface plating, time-kill studies, synergy studies, and electron microscopy were used to investigate further the activity of vancomycin against B31. The MBC of vancomycin was 2 ,ug/ml. Time-kill curves demonstrated .3-loglounit (99.9%o) killing of the final inoculum after 72 h by vancomycin concentrations twice the MIC. Synergy between vancomycin and penicillin was demonstrated at concentrations one-fourth the MIC of each drug. In electron microscopy, B31 cells exposed to vancomycin showed a disruption of cellular integrity and were indistinguishable from those exposed to penicillin. These studies demonstrate another class of microorganisms susceptible in vitro to vancomycin.Lyme disease is the most common arthropod-borne disease in the United States and Europe (36, 39). The disease, caused by the spirochete Borrelia burgdorfien and transmitted primarily by ticks of the genus LIxodes, may be acute and self-limited or may progress to a chronic state with skin, joint, cardiac, and neurological involvement. Although many antibiotics have been used successfully in the treatment of Lyme disease, the full spectrum of antibiotic susceptibility of B. burgdorfien has not been fully defined. B. burgdorferi has been reported to be susceptible in vitro to a variety of antibiotics, including penicillin, amoxicillin, ceftriaxone, cefotaxime, cefuroxime, doxycycline, tetracycline, erythromycin, clarithromycin, and azithromycin (2,15,18,19,31). Oral doxycycline, amoxicillin and, to a lesser extent, erythromycin have been the antibiotics recommended most often for the treatment of the early stages of Lyme disease (11,27,32,36). Recent evidence suggests that oral cefuroxime and azithromycin are also effective in the early stages (23,25). For central nervous system infection and for late complications of Lyme disease, intravenous penicillin G and intravenous ceftriaxone have been the antibiotic therapies most often used (13,14,(36)(37)(38).In the present study, we explored the action of vancomycin, a glycopeptide antibiotic, against borrelias. Although vancomycin is primarily thought of as an antibiotic for use against gram-positive bacteria, we pursued this investigational tack for the following reasons: (i) some gram-negative bacteria, such as certain strains of...

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“…Several cephalosporins, including cefuroxime, cefotaxime, and ceftriaxone, have also been shown to be active agents (1,18). Animal studies parallel in vitro results with the exception that the activity of some of the macrolides in vivo appears to be less than that expected on the basis of in vitro data (11,18 ples obtained from patients with erythema migrans were also studied.…”

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In vitro susceptibility of Borrelia burgdorferi to 11 antimicrobial agents

Levin

Nelson

Segreti

et al. 1993

Antimicrob Agents Chemother

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The in vitro susceptibility of Borrelia burgdorferi to 11 antimicrobial agents was investigated. The antimicrobial agents evaluated included ceftizoxime, FK037, cefotaxime, dirithromycin, clarithromycin and its metabolite 14-hydroxy-clarithromycin, erythromycin, doxycycline, amoxicillin, ciprofloxacin, and ofioxacin.Isolates of B. burgdorferi tested included two reference strains (B31 and ATCC 53899), six isolates from the midwestern United States, and three from Europe. A broth macrodilution method was used to determine MICs and MBCs. B. burgdorferi was inhibited by <0.5 ,ug of each of the agents except the quinolones per ml. The MBCs for 90%o of strains tested of ceftizoxime, FK037, clarithromycin, 14-OH clarithromycin, and dirithromycin (<1.0 jig of each per ml) were superior to those of amoxicillin (2.0 ,ug/ml) and doxycycline (4.0 ,ug/ml).

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In vitro susceptibilities of Borrelia burgdorferi to five oral cephalosporins and ceftriaxone

Abstract: We determined the in vitro susceptibilities of eight Borrelia burgdorferi isolates to five oral cephalosporins.

Cited by 51 publications

References 18 publications

Diagnosis of Lyme Borreliosis

Diagnosis of Lyme Borreliosis

In vitro activity of vancomycin against the spirochete Borrelia burgdorferi

In vitro susceptibility of Borrelia burgdorferi to 11 antimicrobial agents

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