Studies on Antibiotic Synergism and Antagonism: The Interference of Aureomycin, Chloramphenicol and Terramycin With the Action of Streptomycin

Jawetz, Ernest; Gunnison, J. B.; Speck, R. S.

doi:10.1097/00000441-195110000-00006

Cited by 69 publications

(37 citation statements)

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“…This was later confirmed by Manten and Wisse (12). Jawetz et al (9) clearly demonstrated that certain bacteria were killed more slowly by the combination of penicillin and a bacteriostatic antibiotic such as chloramphenicol than by penicillin alone. Interference by chloramphenicol with the early bactericidal effect of penicillin was also reported in experimental group A streptococcal infection in mice (9) and pneumococcal meningitis in dogs (17).…”

Section: Discussionmentioning

confidence: 99%

Antagonism of ampicillin and chloramphenicol for meningeal isolates of group B streptococci

Weeks¹,

Mason²,

Baker³

1981

Antimicrob Agents Chemother

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The increasing prevalence of ampicillin-resistant Haemophilus influenzae type b has led to the recomxniendation that ampicillin and chloramphenicol be given as the initial therapy for suspected bacterial meningitis in infants and children. However, during the first 2 months of life, H. influenzae type b is a rare cause of meningitis, whereas group B streptococcus is the most frequently isolated agent. Since ampicillin and chloramphenicol have been shown to be antagonistic for other streptococci, an in vitro study of their effect on group B streptococci was performed. The effect of ampicillin and chloramphenicol, alone and in combination, on 18 meningeal isolates was determined for 2 different inocula of group B streptococci, using microtiter broth dilution and growth kinetic assays. Isoboles, fractional lethal concentration indices, or both indicated antagonism for all strains. Growth kinetic assays for two representative strains demonstrated inhibition of the early bactericidal activity of ampicillin by chloramphenicol. These findings of in vitro antagonism suggest that this combination may be contraindicated for the treatment of infants with group B streptococcal meningitis.Because of the emergence of ampicillin-resistant Haemophilus influenzae type b strains, a combination of ampicillin with chloramphenicol has been recommended since 1974 as initial antibiotic therapy for bacterial meningitis beyond the neonatal period (2). This recommendation may lead to the occasional treatment of infants less than 2 months of age with this combination, although H. influenzae type b is infrequently isolated from infants in this age group with meningitis (1,15,19,20).In vitro and some in vivo studies have indicated that chloramphenicol in combination with a penicillin is antagonistic for some bacterial species. For example, interference with the early bactericidal effect of penicillin was reported by Wallace et al. (17) in an animal model of pneumococcal meningitis. Similarly, Mathies et al. (13) observed an increased case-fatality ratio among children and adults with bacterial meningitis who were treated with the combination of ampicillin, chloramphenicol, and streptomycin compared with those who were treated with ampicillin alone.Because group B streptococci (GBS) are the single most frequent agents isolated in our medical center from infants less than 2 months of age with bacterial meningitis (1), we believed it important to evaluate the in vitro effect of ampicillin and chloramphenicol against several meningeal isolates. MATERIALS AND METHODSBacterial isolates. Eighteen cerebrospinal fluid (CSF) isolates of GBS from infants <2 months of age were serotyped by the capillary precipitin method of McCarty and Lancefield (14). The serotype distribution of these strains was representative of that reported among neonatal meningeal isolates (18)

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Section: Discussionmentioning

confidence: 99%

Antagonism of ampicillin and chloramphenicol for meningeal isolates of group B streptococci

Weeks¹,

Mason²,

Baker³

1981

Antimicrob Agents Chemother

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“…Previous studies suggested that this combination was less active than penicillin alone against susceptible bacteria both in vitro and in animal models (4,6,9,(17)(18)(19)31). However, recent data failed to demonstrate antagonism of this combination against H. influenzae using a checkerboard technique (1,12); clinical evaluations have been inconclusive (2,3,14,15,22,26,32 The effect of each antibiotic combination was assessed by comparison of mean bacterial densities and by evaluation of the effect of each antibiotic combination on each strain.…”

Section: Recognition Of Ampicillin-resistant (Ampr)mentioning

confidence: 98%

“…MICs of the strains were not reported. Rahal (4,18,31). To ensure non-antagonistic combination chemotherapy for bacterial meningitis or sepsis of unknown etiology, the effect of Amp and Cm on other common pathogens should be examined.…”

Section: Recognition Of Ampicillin-resistant (Ampr)mentioning

confidence: 99%

Effect of Ampicillin and Chloramphenicol Alone and in Combination on Ampicillin-Susceptible and -Resistant Haemophilus influenzae Type B

Cole

Daum

Teller

et al. 1979

Antimicrob Agents Chemother

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To evaluate ampicillin (Amp) and chloramphenicol (Cm) Recognition of ampicillin-resistant (Ampr) Haemophilus influenzae led to the recommendation that initial treatment of children with bacterial meningitis of unknown etiology include a penicillin (penicillin G or Amp) and chloramphenicol (Cm) (8). Previous studies suggested that this combination was less active than penicillin alone against susceptible bacteria both in vitro and in animal models (4,6,9,(17)(18)(19)31). However, recent data failed to demonstrate antagonism of this combination against H. influenzae using a checkerboard technique (1,12); clinical evaluations have been inconclusive (2,3,14,15,22,26,32). We therefore examined the effects of Amp and Cm alone and in combination on H. influenzae type b (Hib), using a killingcurve technique.(These data were presented at The American

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“…Besides its bacteriostatic activity, another important mitigating factor in the use of chloramphenicol for GNBM is its potential for antagonism of concomitantly used bactericidal antibiotics with resultant bacteriostasis. Antibiotic antagonism was first demonstrated in vitro for penicillin by chloramphenicol against streptococci and K. pneumoniae (8). Chloramphenicol also antagonizes the action of penicillin in vivo.…”

Section: Resultsmentioning

confidence: 99%

Antagonism by chloramphenicol of broad-spectrum beta-lactam antibiotics against Klebsiella pneumoniae

Brown¹,

Alford²

1984

Antimicrob Agents Chemother

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Studies on Antibiotic Synergism and Antagonism: The Interference of Aureomycin, Chloramphenicol and Terramycin With the Action of Streptomycin

Cited by 69 publications

References 0 publications

Antagonism of ampicillin and chloramphenicol for meningeal isolates of group B streptococci

Antagonism of ampicillin and chloramphenicol for meningeal isolates of group B streptococci

Effect of Ampicillin and Chloramphenicol Alone and in Combination on Ampicillin-Susceptible and -Resistant Haemophilus influenzae Type B

Antagonism by chloramphenicol of broad-spectrum beta-lactam antibiotics against Klebsiella pneumoniae

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