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Efficacy of Colistin versus β-Lactams, Aminoglycosides, and Rifampin as Monotherapy in a Mouse Model of Pneumonia Caused by Multiresistant Acinetobacter baumannii
- Source :
- Antimicrobial Agents and Chemotherapy. 46:1946-1952
- Publication Year :
- 2002
- Publisher :
- American Society for Microbiology, 2002.
-
Abstract
- The treatment of life-threatening infections due to carbapenem-resistant Acinetobacter baumannii has become a serious challenge for physicians worldwide. Often, only colistin shows in general good in vitro activity against these carbapenem-resistant strains, but its antibacterial efficacy in comparison with the antibiotics most used in clinical practice is not well known. We studied the efficacy of colistin versus those of imipenem, sulbactam, tobramycin, and rifampin in an experimental pneumonia model with immunocompetent mice. We used three strains of A. baumannii corresponding to the main clones (A, D, and E) involved in the outbreaks of our hospital, with different grades of resistance to imipenem (imipenem MICs of 1, 8, and 512 μg/ml, respectively) and to the other antibiotics. The MIC of colistin was 0.5 μg/ml for the three strains. Reduction of log 10 CFU/g in lung bacterial counts, clearance of bacteremia, and survival versus results with controls were used as parameters of efficacy. Imipenem and sulbactam (Δlung counts: −5.38 and −4.64 log 10 CFU/ml) showed the highest level of bactericidal efficacy in infections by susceptible and even intermediate strains. Tobramycin and rifampin (−4.16 and −5.15 log 10 CFU/ml) provided good results against intermediate or moderately resistant strains, in agreement with killing curves and pharmacodynamics. On the contrary, colistin showed the weakest antibacterial effect among the antibiotics tested, both in killing curves and in the in vivo model (−2.39 log 10 CFU/ml; P < 0.05). We conclude that colistin did not appear as a good option for treatment of patients with pneumonia due to carbapenem-resistant A. baumannii strains. Other alternatives, including combinations with rifampin, may offer better therapeutic profiles and thus should be studied.
- Subjects :
- Imipenem
medicine.drug_class
Antibiotics
Microbial Sensitivity Tests
Microbiology
Mice
Pneumonia, Bacterial
polycyclic compounds
medicine
Tobramycin
Animals
Experimental Therapeutics
Pharmacology (medical)
Lung
Antibacterial agent
Pharmacology
Acinetobacter
biology
Colistin
Drug Resistance, Microbial
Sulbactam
biochemical phenomena, metabolism, and nutrition
bacterial infections and mycoses
biology.organism_classification
Survival Analysis
Anti-Bacterial Agents
Acinetobacter baumannii
Mice, Inbred C57BL
Aminoglycosides
Infectious Diseases
bacteria
Female
Rifampin
Acinetobacter Infections
medicine.drug
Subjects
Details
- ISSN :
- 10986596 and 00664804
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Agents and Chemotherapy
- Accession number :
- edsair.doi.dedup.....6c6bccea2f910994d8bca15000fb163e