In Vitro Studies of Investigational Beta-lactams As Possible Therapy for Pseudomonas Aeruginosa Endocarditis

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 1985 Jan 1

PMID 3920956

Citations 3

Authors

F A Zar

R J Kany Jr

Affiliations

Soon will be listed here.

Abstract

The inadequacy of the present medical therapy of Pseudomonas aeruginosa endocarditis prompted an investigation of the in vitro activities of aztreonam, cefsulodin, and imipenem compared with that of ticarcillin against 37 strains of P. aeruginosa isolated from patients with endocarditis. Inhibitory and bactericidal activities were studied for each beta-lactam alone and in combination with tobramycin. All agents showed excellent inhibitory activity. Imipenem was the most inhibitory beta-lactam yet lacked inhibitory synergy against 95% of the strains and bactericidal synergy against 62%. Tolerance to imipenem was seen in six strains. Aztreonam alone was bactericidal against 46% of the strains (at 16 micrograms/ml) and showed bactericidal synergy in 70%. Cefsulodin alone was even less active but similar to aztreonam synergistically. Ticarcillin and tobramycin inhibited all strains as single agents and showed universal bactericidal synergy in combination. None of the new beta-lactams showed consistent superiority to the presently used agent, ticarcillin.

Citing Articles

Rapid conversion of Pseudomonas aeruginosa to a spherical cell morphotype facilitates tolerance to carbapenems and penicillins but increases susceptibility to antimicrobial peptides.

Monahan L, Turnbull L, Osvath S, Birch D, Charles I, Whitchurch C Antimicrob Agents Chemother. 2014; 58(4):1956-62.

PMID: 24419348 PMC: 4023726. DOI: 10.1128/AAC.01901-13.

Efficacy of ceftazidime and aztreonam alone or in combination with amikacin in experimental left-sided Pseudomonas aeruginosa endocarditis.

Pefanis A, Giamarellou H, Karayiannakos P, Donta I Antimicrob Agents Chemother. 1993; 37(2):308-13.

PMID: 8452362 PMC: 187658. DOI: 10.1128/AAC.37.2.308.

Serum bactericidal activity and killing rate for volunteers receiving imipenem, imipenem plus amikacin, and ceftazidime plus amikacin against Pseudomonas aeruginosa.

Van der Auwera P, Klastersky J, Lagast H, Husson M Antimicrob Agents Chemother. 1986; 30(1):122-6.

PMID: 3092729 PMC: 176448. DOI: 10.1128/AAC.30.1.122.

References

Layte S, Harris P, Rolinson G . Factors affecting the apparent regrowth of Pseudomonas aeruginosa following exposure to bactericidal concentrations of carbenicillin. Chemotherapy. 1984; 30(1):26-30. DOI: 10.1159/000238240. View

Adkinson Jr N, Swabb E, SUGERMAN A . Immunology of the monobactam aztreonam. Antimicrob Agents Chemother. 1984; 25(1):93-7. PMC: 185442. DOI: 10.1128/AAC.25.1.93. View

Shanholtzer C, Peterson L, Mohn M, Moody J, Gerding D . MBCs for Staphylococcus aureus as determined by macrodilution and microdilution techniques. Antimicrob Agents Chemother. 1984; 26(2):214-9. PMC: 284123. DOI: 10.1128/AAC.26.2.214. View

Reyes M, Brown W, Smith F, Lerner A . Synergy between carbenicillin and an aminoglycoside (gentamicin or tobramycin) against Pseudomonas aeruginosa isolated from patients with endocarditis and sensitivity of isolates to normal human serum. J Infect Dis. 1979; 140(2):192-202. DOI: 10.1093/infdis/140.2.192. View

Neu H, Fu K . In vitro antibacterial activity and beta-lactamase stability of SCE-129, a new cephalosporin. Antimicrob Agents Chemother. 1979; 15(5):646-50. PMC: 352731. DOI: 10.1128/AAC.15.5.646. View

Daschner F, Metz B, Spillner G, Buzello W, Schlosser V . Concentrations of cefamandole and cefsulodin in serum, heart valves, subcutaneous tissue, and muscle of patients undergoing open-heart surgery. J Infect Dis. 1980; 142(2):290. DOI: 10.1093/infdis/142.2.290. View

Rajashekaraiah K, Rice T, Rao V, Marsh D, Ramakrishna B, Kallick C . Clinical significance of tolerant strains of Staphylococcus aureus in patients with endocarditis. Ann Intern Med. 1980; 93(6):796-801. DOI: 10.7326/0003-4819-93-6-796. View

Gwynn M, Webb T, Rolinson G . Regrowth of Pseudomonas aeruginosa and other bacteria after the bactericidal action of carbenicillin and other beta-lactam antibiotics. J Infect Dis. 1981; 144(3):263-9. DOI: 10.1093/infdis/144.3.263. View

Muytjens H . Comparative activities of 13 beta-lactam antibiotics. Antimicrob Agents Chemother. 1982; 21(6):925-34. PMC: 182047. DOI: 10.1128/AAC.21.6.925. View

10.

Farmer 3rd J, Weinstein R, Zierdt C, Brokopp C . Hospital outbreaks caused by Pseudomonas aeruginosa: importance of serogroup O11. J Clin Microbiol. 1982; 16(2):266-70. PMC: 272342. DOI: 10.1128/jcm.16.2.266-270.1982. View

11.

Auckenthaler R, Wilson W, Wright A, Washington 2nd J, Durack D, GERACI J . Lack of in vivo and in vitro bactericidal activity of N-formimidoyl thienamycin against enterococci. Antimicrob Agents Chemother. 1982; 22(3):448-52. PMC: 183764. DOI: 10.1128/AAC.22.3.448. View

12.

Jacobus N, Ferreira M, Barza M . In vitro activity of azthreonam, a monobactam antibiotic. Antimicrob Agents Chemother. 1982; 22(5):832-8. PMC: 185668. DOI: 10.1128/AAC.22.5.832. View

13.

Swabb E, SUGERMAN A, MCKINSTRY D . Multiple-dose pharmacokinetics of the monobactam azthreonam (SQ 26,776) in healthy subjects. Antimicrob Agents Chemother. 1983; 23(1):125-32. PMC: 184629. DOI: 10.1128/AAC.23.1.125. View

14.

Reyes M, Lerner A . Current problems in the treatment of infective endocarditis due to Pseudomonas aeruginosa. Rev Infect Dis. 1983; 5(2):314-21. DOI: 10.1093/clinids/5.2.314. View

15.

Matzke G, Keane W . Cefsulodin pharmacokinetics in patients with various degrees of renal function. Antimicrob Agents Chemother. 1983; 23(3):369-73. PMC: 184654. DOI: 10.1128/AAC.23.3.369. View

16.

CONROY J, Baltch A, Smith R, Hammer M, GRIFFIN P . Bacteremia due to Pseudomonas aeruginosa: use of a combined typing system in an eight-year study. J Infect Dis. 1983; 148(3):603. DOI: 10.1093/infdis/148.3.603. View