Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1996 Sep;40(9):1973–1976. doi: 10.1128/aac.40.9.1973

Antipneumococcal activities of cefpirome and cefotaxime, alone and in combination with vancomycin and teicoplanin, determined by checkerboard and time-kill methods.

S Bajaksouzian 1, M A Visalli 1, M R Jacobs 1, P C Appelbaum 1
PMCID: PMC163457  PMID: 8878565

Abstract

The checkerboard titration method was used to test the synergy of cefpirome and cefotaxime with teicoplanin or vancomycin against 35 penicillin-susceptible, 34 penicillin-intermediate, and 31 penicillin-resistant pneumococci. The MICs at which 50 and 90% of isolates are inhibited (MIC50s and MIC90s, respectively) of both cefpirome and cefotaxime were 0.016 and 0.06 microgram/ml, respectively, for penicillin-susceptible strains and 0.125 and 0.5 microgram/ml, respectively, for penicillin-intermediate strains. The MIC50s and MIC90s of cefotaxime for penicillin-resistant strains were 1.0 and 2.0 micrograms/ml, respectively, and those of cefpirome were 0.5 and 1.0 microgram/ml, respectively. All pneumococci were inhibited by cefpirome at MICs of < or = 1.0 microgram/ml. The MIC50s and MIC90s of vancomycin and teicoplanin (0.25 and 0.25 microgram/ml and 0.03 and 0.03 microgram/ml, respectively) did not differ for the three groups. Checkerboard synergy studies showed that cefpirome and vancomycin showed synergy for 31 strains (fractional inhibitory concentration [FIC] indices, < or = 0.5) cefpirome and teicoplanin showed synergy for 18 strains, cefotaxime and vancomycin showed synergy for 51 strains, and cefotaxime and teicoplanin showed synergy for 27 strains. Cefpirome and vancomycin had FIC indices indicating indifference (2.0) for two strains, and cefotaxime and vancomycin had FIC indices indicating indifference for one strain. All other FIC indices indicating indifference or additivity were > 0.5 to 1.0. No FIC indices indicating antagonism (> 4.0) were found. Synergy between beta-lactams and glycopeptides for three susceptible, three intermediate, and three resistant strains were tested by the time-kill assay, and all combinations were synergistic by this method. Synergy between cephalosporins and glycopeptides can be demonstrated and may be useful for the treatment of pneumococcal infections, especially meningitis.

Full Text

The Full Text of this article is available as a PDF (192.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. Barry A. L., Brown S. D., Novick W. J. In vitro activities of cefotaxime, ceftriaxone, ceftazidime, cefpirome, and penicillin against Streptococcus pneumoniae isolates. Antimicrob Agents Chemother. 1995 Oct;39(10):2193–2196. doi: 10.1128/aac.39.10.2193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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]
  4. Fitoussi F., Doit C., Sandin A., Pechinot A., Kazmierczack A., Geslin P., Bingen E. Killing activity of cefpirome against penicillin-resistant Streptococcus pneumoniae isolates from patients with meningitis in a pharmacodynamic model simulating the cerebrospinal fluid concentration profile. Antimicrob Agents Chemother. 1995 Nov;39(11):2560–2563. doi: 10.1128/aac.39.11.2560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. 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]
  6. 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]
  7. Friedland I. R., Paris M., Ehrett S., Hickey S., Olsen K., McCracken G. H., Jr Evaluation of antimicrobial regimens for treatment of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis. Antimicrob Agents Chemother. 1993 Aug;37(8):1630–1636. doi: 10.1128/aac.37.8.1630. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goldstein F. W., Geslin P., Acar J. F. Comparative activity of teicoplanin and vancomycin against 400 penicillin susceptible and resistant Streptococcus pneumoniae. The French Study Group. Eur J Clin Microbiol Infect Dis. 1994 Jan;13(1):33–34. doi: 10.1007/BF02026121. [DOI] [PubMed] [Google Scholar]
  9. Hofmann J., Cetron M. S., Farley M. M., Baughman W. S., Facklam R. R., Elliott J. A., Deaver K. A., Breiman R. F. The prevalence of drug-resistant Streptococcus pneumoniae in Atlanta. N Engl J Med. 1995 Aug 24;333(8):481–486. doi: 10.1056/NEJM199508243330803. [DOI] [PubMed] [Google Scholar]
  10. 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]
  11. Klugman K. P., Friedland I. R., Bradley J. S. Bactericidal activity against cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with acute bacterial meningitis. Antimicrob Agents Chemother. 1995 Sep;39(9):1988–1992. doi: 10.1128/aac.39.9.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. 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]
  13. 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]
  14. 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]
  15. París M. M., Ramilo O., McCracken G. H., Jr Management of meningitis caused by penicillin-resistant Streptococcus pneumoniae. Antimicrob Agents Chemother. 1995 Oct;39(10):2171–2175. doi: 10.1128/aac.39.10.2171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. 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]
  17. 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]
  18. 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]
  19. Täuber M. G., Hackbarth C. J., Scott K. G., Rusnak M. G., Sande M. A. New cephalosporins cefotaxime, cefpimizole, BMY 28142, and HR 810 in experimental pneumococcal meningitis in rabbits. Antimicrob Agents Chemother. 1985 Mar;27(3):340–342. doi: 10.1128/aac.27.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. 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]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES