Paradoxical Effect of Cloxacillin and Benzylpenicillin against Clinical Isolates of <i>Staphylococcus aureus</i>

Abstract

The occurrence of a paradoxical effect of cloxacillin and benzylpenicillin in 7 strains of Staphylococcus aureus was studied with time killing curves in vitro. The isolates were exposed to 1,2, 10 and 100 x MIC of the antibiotics. A paradoxical effect was found in 5/7 strains with cloxacillin and in 4/7 with benzylpenicillin. All strains were killed faster with 2 x MIC than with 100 x MIC. All strains that showed a paradoxical effect with cloxacillin did so already at 10 x MIC. For benzylpenicillin the effect occurred at 10 x MIC for 2 strains and at 100 x MIC for 2. A single MBC/MIC ratio will not reveal the paradoxical effect.