In vitro activity of parenteral Beta-lactams, levofloxacin and tobramycin alone or in combination against extended-spectrum Beta-lactamase producing Klebsiella pneumoniae

International Journal of Antimicrobial Agents
David S Burgess, Ronald G Hall

Abstract

MICs and time-kill studies were performed for four clinical isolates of extended-spectrum Beta-lactamase (ESBL)-producing Klebsiella pneumoniae. MICs (mg/L) were: piperacillin/tazobactam 8, cefepime 1-2, meropenem 0.03-0.06, levofloxacin 0.5-8 and tobramycin 0.25-32. For monotherapy, only meropenem maintained bactericidal activity over the 24 h for all isolates. Levofloxacin and tobramycin maintained bactericidal activity against the isolate susceptible to each drug. Piperacillin/tazobactam and cefepime did not maintain bactericidal activity against any isolate. Combination therapy with piperacillin/tazobactam or cefepime combined with levofloxacin or tobramycin were able to provide dramatic killing against ESBL K. pneumoniae, but did not always maintain bactericidal activity. Future studies should evaluate different antimicrobial combinations against pathogens producing specific ESBL enzymes to define their utility as an alternative to carbapenems.

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Citations

Dec 8, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David CluckJonathan Moorman
Oct 30, 2020·ACS Applied Materials & Interfaces·Nithil Harris ManimaranTagbo H R Niepa

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