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False synergy between vancomycin and beta-lactams against glycopeptide-intermediate Staphylococcus aureus (GISA)
F W Goldstein1, R Atoui, A Ben Ali
1Fondation Hospital Saint-Joseph, 185 rue Raymond Losserand, 75014 Paris, France. fgoldstein@hospital-saint-joseph.org
Abstract:
The combination of vancomycin and beta-lactams is often considered synergistic and has been recommended for the treatment of glycopeptide-intermediate Staphylococcus aureus (GISA) infections. In this study, the combination of vancomycin or teicoplanin with different beta-lactams was tested. When using NaCl 4% w/v, for better expression of heterogeneous resistance to beta-lactams, with a longer (48-h) incubation period and a higher (10(7) CFU/mL) inoculum, the association of vancomycin with beta-lactams was antagonistic. However, a synergistic effect was observed for teicoplanin under the same conditions.