Abstract
MIC and time-kill methods were used to test the activities of DU-6859a, ciprofloxacin, levofloxacin, sparfloxacin, cefotaxime, imipenem, and vancomycin against nine penicillin-susceptible, -intermediate, and -resistant pneumococci. The MIC of penicillin for penicillin-susceptible strains was 0.016 micrograms/ml, those for intermediate strains were 0.25 to 1.0 microgram/ml, and those for resistant strains were 2.0 to 4.0 micrograms/ml. Of the four quinolones tested, DU-6859a had the lowest MIC (0.064 micrograms/ml), followed by sparfloxacin (0.25 to 0.5 micrograms/ml) and levofloxacin and ciprofloxacin (both 1.0 to 4.0 micrograms/ml). Vancomycin inhibited all strains at MICs of 0.25 to 0.5 micrograms/ml. The MICs of imipenem and cefotaxime for penicillin-susceptible, -intermediate, and -resistant strains were 0.004 to 0.008, 0.008 to 0.032, and 0.25 micrograms/ml and 0.016, 0.125 to 0.5, and 2.0 micrograms/ml, respectively. DU-6859a was bactericidal at eight times the MICs (0.5 micrograms/ml) for seven of the nine strains after 4 h and bactericidal for all nine strains after 6 h at eight times the MICs and after 12 h at two times the MICs. By comparison, sparfloxacin, the next most active quinolone, was uniformly bactericidal at two times the MICs only after 24 h, with little activity after 2 h. Levofloxacin and ciprofloxacin were bactericidal against all strains after 12 h at eight times the MICs and against all strains at 24 h at four times the MICs. Imipenem was bactericidal against all strains, at concentrations exceeding the MICs, after 24 h. Cefotaxime was also uniformly bactericidal only after 24 h of incubation at two times the MICs. Vancomycin, despite having uniformly low MICs for all strains irrespective of their penicillin susceptibility, was uniformly bactericidal only at two times the MICs after 24 h.
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- Appelbaum P. C. Antimicrobial resistance in Streptococcus pneumoniae: an overview. Clin Infect Dis. 1992 Jul;15(1):77–83. doi: 10.1093/clinids/15.1.77. [DOI] [PubMed] [Google Scholar]
- Breiman R. F., Butler J. C., Tenover F. C., Elliott J. A., Facklam R. R. Emergence of drug-resistant pneumococcal infections in the United States. JAMA. 1994 Jun 15;271(23):1831–1835. [PubMed] [Google Scholar]
- Friedland I. R., Istre G. R. Management of penicillin-resistant pneumococcal infections. Pediatr Infect Dis J. 1992 Jun;11(6):433–435. doi: 10.1097/00006454-199206000-00002. [DOI] [PubMed] [Google Scholar]
- Friedland I. R., McCracken G. H., Jr Management of infections caused by antibiotic-resistant Streptococcus pneumoniae. N Engl J Med. 1994 Aug 11;331(6):377–382. doi: 10.1056/NEJM199408113310607. [DOI] [PubMed] [Google Scholar]
- Jacobs M. R. Treatment and diagnosis of infections caused by drug-resistant Streptococcus pneumoniae. Clin Infect Dis. 1992 Jul;15(1):119–127. doi: 10.1093/clinids/15.1.119. [DOI] [PubMed] [Google Scholar]
- Jolley A., Andrews J. M., Brenwald N., Wise R. The in-vitro activity of a new highly active quinolone, DU-6859a. J Antimicrob Chemother. 1993 Nov;32(5):757–763. doi: 10.1093/jac/32.5.757. [DOI] [PubMed] [Google Scholar]
- Korten V., Tomayko J. F., Murray B. E. Comparative in vitro activity of DU-6859a, a new fluoroquinolone agent, against gram-positive cocci. Antimicrob Agents Chemother. 1994 Mar;38(3):611–615. doi: 10.1128/aac.38.3.611. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marshall S. A., Jones R. N. In vitro activity of DU-6859a, a new fluorocyclopropyl quinolone. Antimicrob Agents Chemother. 1993 Dec;37(12):2747–2753. doi: 10.1128/aac.37.12.2747. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marshall S. A., Jones R. N., Murray P. R., Washington J. A., Allen S. D., Gerlach E. H., Erwin M. E. In-vitro comparison of DU-6859a, a novel fluoroquinolone, with other quinolones and oral cephalosporins tested against 5086 recent clinical isolates. J Antimicrob Chemother. 1993 Dec;32(6):877–884. doi: 10.1093/jac/32.6.877. [DOI] [PubMed] [Google Scholar]
- McDougal L. K., Facklam R., Reeves M., Hunter S., Swenson J. M., Hill B. C., Tenover F. C. Analysis of multiply antimicrobial-resistant isolates of Streptococcus pneumoniae from the United States. Antimicrob Agents Chemother. 1992 Oct;36(10):2176–2184. doi: 10.1128/aac.36.10.2176. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Munoz R., Musser J. M., Crain M., Briles D. E., Marton A., Parkinson A. J., Sorensen U., Tomasz A. Geographic distribution of penicillin-resistant clones of Streptococcus pneumoniae: characterization by penicillin-binding protein profile, surface protein A typing, and multilocus enzyme analysis. Clin Infect Dis. 1992 Jul;15(1):112–118. doi: 10.1093/clinids/15.1.112. [DOI] [PubMed] [Google Scholar]
- Nakashima M., Uematsu T., Kosuge K., Umemura K., Hakusui H., Tanaka M. Pharmacokinetics and tolerance of DU-6859a, a new fluoroquinolone, after single and multiple oral doses in healthy volunteers. Antimicrob Agents Chemother. 1995 Jan;39(1):170–174. doi: 10.1128/aac.39.1.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pankuch G. A., Jacobs M. R., Appelbaum P. C. Study of comparative antipneumococcal activities of penicillin G, RP 59500, erythromycin, sparfloxacin, ciprofloxacin, and vancomycin by using time-kill methodology. Antimicrob Agents Chemother. 1994 Sep;38(9):2065–2072. doi: 10.1128/aac.38.9.2065. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sato K., Hoshino K., Tanaka M., Hayakawa I., Osada Y. Antimicrobial activity of DU-6859, a new potent fluoroquinolone, against clinical isolates. Antimicrob Agents Chemother. 1992 Jul;36(7):1491–1498. doi: 10.1128/aac.36.7.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spangler S. K., Jacobs M. R., Appelbaum P. C. Susceptibilities of 177 penicillin-susceptible and -resistant pneumococci to FK 037, cefpirome, cefepime, ceftriaxone, cefotaxime, ceftazidime, imipenem, biapenem, meropenem, and vancomycin. Antimicrob Agents Chemother. 1994 Apr;38(4):898–900. doi: 10.1128/aac.38.4.898. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spangler S. K., Jacobs M. R., Appelbaum P. C. Susceptibilities of penicillin-susceptible and -resistant strains of Streptococcus pneumoniae to RP 59500, vancomycin, erythromycin, PD 131628, sparfloxacin, temafloxacin, win 57273, ofloxacin, and ciprofloxacin. Antimicrob Agents Chemother. 1992 Apr;36(4):856–859. doi: 10.1128/aac.36.4.856. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spangler S. K., Jacobs M. R., Pankuch G. A., Appelbaum P. C. Susceptibility of 170 penicillin-susceptible and penicillin-resistant pneumococci to six oral cephalosporins, four quinolones, desacetylcefotaxime, Ro 23-9424 and RP 67829. J Antimicrob Chemother. 1993 Feb;31(2):273–280. doi: 10.1093/jac/31.2.273. [DOI] [PubMed] [Google Scholar]
- Spika J. S., Facklam R. R., Plikaytis B. D., Oxtoby M. J. Antimicrobial resistance of Streptococcus pneumoniae in the United States, 1979-1987. The Pneumococcal Surveillance Working Group. J Infect Dis. 1991 Jun;163(6):1273–1278. doi: 10.1093/infdis/163.6.1273. [DOI] [PubMed] [Google Scholar]
- Tweardy D. J., Jacobs M. R., Speck W. T. Susceptibility of penicillin-resistant pneumococci to eighteen antimicrobials: implications for treatment of meningitis. J Antimicrob Chemother. 1983 Aug;12(2):133–139. doi: 10.1093/jac/12.2.133. [DOI] [PubMed] [Google Scholar]
- Viladrich P. F., Gudiol F., Liñares J., Pallarés R., Sabaté I., Rufí G., Ariza J. Evaluation of vancomycin for therapy of adult pneumococcal meningitis. Antimicrob Agents Chemother. 1991 Dec;35(12):2467–2472. doi: 10.1128/aac.35.12.2467. [DOI] [PMC free article] [PubMed] [Google Scholar]