The influence of subminimal inhibitory concentrations of erythromycin, clindamycin, and pristinamycin on the penicillinase production of Staphylococcus aureus was tested in 12 strains. Of the 36 experiments performed, 16 (44%) showed a lack of influence, 10 (28%) displayed an increase, and 10 revealed a decrease in penicillinase activity. The maximal effect produced was generally induced by concentrations ranging from ¼/ to 1/32 the minimal inhibitory concentration, irrespective of the susceptibility of the strain to the drug. In spite of the fact that the drugs are closely related, they sometimes produced opposite effects on the same strain.The problem of the effects of subminimal inhibitory concentrations (subMIC's) of antibacterial drugs has been investigated in the last few years and was recently discussed by Lorian (9) and Rolinson (15). Most of the available data concern the influence of various agents on bacterial growth (2,6,17) and the morphological changes induced by. the subMIC's of f,-lactam antibiotics (4,8,10,12). Only a few papers have dealt with the effects of the subMIC on bacterial enzymatic systems. Inducible enzymes were shown to be affected by the subMIC's of nitrofurans (7) and chloramphenicol (18). Gemmell has reported the influence of the subMIC's of antibiotics, especially .clindamycin, on the biosynthesis of some staphylococcal toxins and enzymes during experimental pyogenic infection (5). We have shown that the subMIC of chloramphenicol can inhibit ,8-lactamase production in gram-negative bacilli (13) and in Staphylococcus aureus (14) and that this inhibition sometimes leads to a synergistic bactericidal effect in vitro (13,14) and in vivo (16). More recently, Allen and Epp have shown that erythromycin can inhibit penicillinase induction in strains of S. aureus (1). To the best of our knowledge, a comparative study on the effect ofclosely related drugs on penicillinase production has not been reported in the literature. The purpose of the present paper was, therefore, to investigate the influence of subMIC's of erythromycin, clindamycin, and pristinamycin on the penicillinase production of strains of S. aureus.
MATERIALS AND METHODSTwelve strains of penicillin G-resistant S. aureus were used. These were isolated in the diagnostic laboratory of the Department of Clinical Microbiology, Hadassah University Hospital, Mount Scopus, Jerusalem, from sputum, wound exudates, urine, and blood. Each was tested for ,B-lactamase production by the iodometric method, as described by Workman and Farrar (21). The minimal inhibitory concentrations (MICs) of erythromycin, clindamycin, and pristinamycin for these strains were determined by using a microdilution technique. Serial twofold dilutions of the antibiotic were made in tryptic soy broth (TSB; Difco Laboratories) in sterile Microtiter U-plates (Cook Engineering Co.). A suitable dilution of a 4-h culture of the bacteria in TSB at 37°C was prepared in TSB and added to the wells of the microtiter plates to give a final inoculum of 10' colony-forming ...