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In vitro antimicrobial activity of imipenem in combination with vancomycin or teicoplanin against Staphylococcus
Abstract:
The interaction between imipenem and two glycopeptides against staphylococci was examined for potential synergy. Imipenem in combination with vancomycin or teicoplanin exerted a synergistic or additive effect against a majority of Staphylococcus aureus and Staphylococcus epidermidis isolates tested by the checkerboard method. Synergistic inhibitory effects were frequently accompanied by synergistic bactericidal effects. For a proportion of bacterial isolates of both species, the demonstration of synergy by the checkerboard method was confirmed by time-kill studies using antibiotic combinations at the MICs or at achievable serum antibiotic levels. Only with a single isolate of Staphylococcus epidermidis was antagonism with either antibiotic combination recorded.
Insights
Imipenem combined with vancomycin or teicoplanin showed synergistic effects against most Staphylococcus strains. This antibiotic combination therapy offers potential for enhanced treatment of staphylococcal infections.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Staphylococci are significant human pathogens.
- Antibiotic resistance in staphylococci is a growing concern.
- Combination therapy is explored to enhance antimicrobial efficacy.
Purpose of the Study:
- To investigate the synergistic potential of imipenem combined with glycopeptides (vancomycin, teicoplanin) against staphylococcal isolates.
- To evaluate both inhibitory and bactericidal effects of these combinations.
Main Methods:
- Checkerboard method was used to assess drug interactions.
- Time-kill studies confirmed synergy at relevant antibiotic concentrations.
- Tested against clinical isolates of Staphylococcus aureus and Staphylococcus epidermidis.
Main Results:
- A majority of Staphylococcus aureus and Staphylococcus epidermidis isolates showed synergistic or additive effects with imipenem-glycopeptide combinations.
- Synergistic inhibitory effects often correlated with synergistic bactericidal activity.
- Antagonism was observed in only one Staphylococcus epidermidis isolate.
Conclusions:
- Imipenem in combination with vancomycin or teicoplanin demonstrates significant synergistic potential against staphylococci.
- This combination therapy may represent a viable strategy for treating staphylococcal infections, including those with reduced susceptibility.
- Further clinical investigation is warranted to validate these findings in patient populations.