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[In vitro synergistic effects of tazobactam/piperacillin with various antibiotics]

K Nishida1, K Niidome, M Hashimoto

  • 1Department of Microbiology, Kyoto Pharmaceutical University.

Insights

The combination of tazobactam/piperacillin with aminoglycosides or fosfomycin shows synergistic effects against Pseudomonas aeruginosa, Serratia marcescens, and MRSA. These combinations demonstrate enhanced bactericidal activity, offering potential for treating resistant bacterial infections.

Area of Science:

  • Microbiology
  • Pharmacology
  • Infectious Diseases

Background:

  • Antibiotic resistance is a growing global health threat.
  • Beta-lactamase-producing bacteria, including MRSA, pose significant treatment challenges.
  • Combination antibiotic therapy is explored to overcome resistance mechanisms.

Purpose of the Study:

  • To investigate the in vitro synergistic effects of tazobactam/piperacillin (TAZ/PIPC) in combination with other antibiotics.
  • To evaluate the efficacy of these combinations against key resistant pathogens: Pseudomonas aeruginosa, Serratia marcescens, and methicillin-resistant Staphylococcus aureus (MRSA).
  • To determine the morphological changes induced by effective drug combinations.

Main Methods:

  • Checkerboard dilution method was employed to assess synergistic effects.
  • Fractional Inhibitory Concentration (FIC) index was calculated to quantify synergy.
  • Phase-contrast microscopy was used to observe bacterial cell morphology.

Main Results:

  • Synergistic effects were observed for TAZ/PIPC combined with tobramycin, netilmicin, fosfomycin, ciprofloxacin, minocycline, or cefoperazone against all tested bacteria.
  • The most effective combinations were TAZ/PIPC with netilmicin against P. aeruginosa (FIC index 0.459) and TAZ/PIPC with fosfomycin against S. marcescens and MRSA.
  • Bactericidal effects were noted for TAZ/PIPC with tobramycin or fosfomycin against specific strains, inducing filamentous cells, spheroplasts, and lysis.

Conclusions:

  • Combination of TAZ/PIPC with aminoglycosides (tobramycin, netilmicin) or fosfomycin exhibits significant in vitro synergy against P. aeruginosa, S. marcescens, and MRSA.
  • These combinations demonstrate enhanced bactericidal activity compared to individual agents.
  • The findings suggest potential utility in treating infections caused by beta-lactamase-producing strains of these pathogens.

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