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Synergy of sulbactam and ampicillin against methicillin-resistant staphylococci
Abstract:
Methicillin resistance in staphylococci is an increasing problem both for Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), which cause infections of the heart and after central nervous system surgery. Resistance seems to be due primarily to production of altered penicillin-binding proteins. The present study determined whether a combination of beta-lactamase inhibitor sulbactam and ampicillin or sulbactam and cefazolin would inhibit MRSA and MRSE. Sulbactam, ampicillin and cefazolin at 32 micrograms/ml did not inhibit MRSA or MRSE. At 8 micrograms/ml of each agent all isolates were inhibited. Synergy of sulbactam and ampicillin could be demonstrated against MRSA by the agar fixed ratio method, checkerboard dilution and by killing curves. This suggests that in certain situations MRSA and MRSE may be effectively eliminated by this method.
Insights
Methicillin-resistant staphylococci (MRSA and MRSE) are a growing concern. A combination of sulbactam and ampicillin showed synergistic effects, potentially eliminating these resistant bacteria.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Methicillin resistance in Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) poses a significant clinical challenge.
- These resistant strains are associated with serious infections, including cardiac and post-neurosurgical infections.
- Altered penicillin-binding proteins are the primary mechanism of methicillin resistance.
Purpose of the Study:
- To evaluate the efficacy of combining sulbactam with ampicillin or cefazolin against MRSA and MRSE.
- To determine inhibitory concentrations and synergistic effects of these antibiotic combinations.
Main Methods:
- Agar fixed ratio method
- Checkerboard dilution assays
- Killing curves
Main Results:
- Neither sulbactam, ampicillin, nor cefazolin alone inhibited MRSA or MRSE at 32 µg/ml.
- All tested isolates were inhibited at 8 µg/ml of each agent.
- Synergistic activity of sulbactam and ampicillin was demonstrated against MRSA using multiple methods.
Conclusions:
- The combination of sulbactam and ampicillin exhibits synergistic effects against methicillin-resistant staphylococci.
- This combination may offer a viable therapeutic option for eliminating MRSA and MRSE infections in specific clinical scenarios.