Journal article
Comparative activity of twelve beta-lactam drugs tested against penicillin-resistant Streptococcus pneumoniae from five medical centers: Effects of serum protein and capsular material on potency and spectrum as measured by reference tests
Diagnostic microbiology and infectious disease, Vol.25(3), pp.137-141
1996
DOI: 10.1016/S0732-8893(96)00126-5
PMID: 8902410
Abstract
A total of 152 strains of
Streptococcus pneumoniae from diverse geographic areas in the United States and with different levels of penicillin resistance were tested against five broad-spectrum cephalosporins, ampicillin, piperacillin, ticarcillin, and three beta-lactamase inhibitor combinations. Also, the effect of human serum proteins on the activity of selected “third-generation” cephalosporins was examined. The overall rank order of activity among the cephalosporins against penicillin-susceptible strains was: ceftriaxone (MIC
90, 0.03 μg/mL) > cefotaxime > ceftizoxime = cefuroxime > ceftazidime (MIC
90, 0.5 μg/mL). Only cefotaxime and ceftriaxone exhibited significant activity against penicillin-intermediate or -resistant isolates. Ampicillin, piperacillin, and penicillin were generally eight- to 16-fold more potent than ticarcillin and no increase in the effectiveness of these agents was observed with the addition of the beta-lactamase inhibitors (clavulanate, sulbactam, tazobactam). Ceftriaxone potency was significantly decreased (⩾four-fold) by the modest addition of 25% pooled human serum proteins and this change modified the rank order of potency against nonpenicillin-susceptible pneumococci to favor cefotaxime (41% resistant versus 71% for ceftriaxone; MICs at ⩾2 μg/mL). Induced high-level capsular production had no measurable effect on the MIC results of tested agents. These results confirm the continued activity advantages of cefotaxime and ceftriaxone against various populations of pneumococci compared to other alternative beta-lactams. The predictive value, however, of the utilized breakpoint concentrations of the cephalosporins, remains in question for pneumococcal infections other than those in the central nervous system and at unaltered, “usual” dosing.
Details
- Title: Subtitle
- Comparative activity of twelve beta-lactam drugs tested against penicillin-resistant Streptococcus pneumoniae from five medical centers: Effects of serum protein and capsular material on potency and spectrum as measured by reference tests
- Creators
- David M Johnson - From the University of Iowa College of Medicine, Iowa City, Iowa, USAGary V Doern - University of Massachusettes Medical Center, Worcester, Massachusetts, USAThomas A Haugen - Department of Veterans Affairs Medical Center, Iowa City, Iowa, USAJanet Hindler - University of California Medical Center, Los Angeles, California, USAJohn A Washington - The Cleveland Clinic Foundation, Cleveland, Ohio, U.S.ARonald N Jones - From the University of Iowa College of Medicine, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Diagnostic microbiology and infectious disease, Vol.25(3), pp.137-141
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0732-8893(96)00126-5
- PMID
- 8902410
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Language
- English
- Date published
- 1996
- Academic Unit
- Epidemiology; Pathology
- Record Identifier
- 9984047643402771
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