Abstract
We conducted time-kill studies to evaluate the inhibitory activities of either cefotaxime or minocycline alone and the two drugs in combination against a clinical strain of Vibrio vulnificus. The MICs of cefotaxime and minocycline were 0.03 and 0.06 microg/ml, respectively. When approximately 5 x 10(5) CFU of V. vulnificus per ml was incubated with cefotaxime at 0.03 or 0.05 microg/ml, the bacterial growth was inhibited during the initial 2 and 8 h, respectively. Thereafter, V. vulnificus regrew and the level of growth reached that of the control. Within the dose range of less than five times the MIC, the duration of the inhibitory effect of cefotaxime was proportional to its concentration. When minocycline at 0.015, 0.03, 0.045, and 0.06 microg/ml was used to evaluate the inhibitory effect, a similar trend was observed. Either antibiotic at a concentration of five times the MIC or greater prevented the regrowth of V. vulnificus for at least 48 h. When cefotaxime at 0.05 microg/ml and minocycline at 0.045 microg/ml were combined in the same culture, the inhibitory effect against V. vulnificus persisted for more than 48 h, with no regrowth noted. The use of a combination of these two antibiotics resulted in the reduction of growth by 6 orders of magnitude compared to the use of either of the two antibiotics alone, and the number of surviving organisms in the presence of the antibiotics combined was approximately 3 orders of magnitude less than that in the starting inoculum. We conclude that cefotaxime and minocycline acted synergistically in inhibiting V. vulnificus in vitro.
Full Text
The Full Text of this article is available as a PDF (162.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blake P. A., Merson M. H., Weaver R. E., Hollis D. G., Heublein P. C. Disease caused by a marine Vibrio. Clinical characteristics and epidemiology. N Engl J Med. 1979 Jan 4;300(1):1–5. doi: 10.1056/NEJM197901043000101. [DOI] [PubMed] [Google Scholar]
- Bonner J. R., Coker A. S., Berryman C. R., Pollock H. M. Spectrum of Vibrio infections in a Gulf Coast community. Ann Intern Med. 1983 Oct;99(4):464–469. doi: 10.7326/0003-4819-99-4-464. [DOI] [PubMed] [Google Scholar]
- Bowdre J. H., Hull J. H., Cocchetto D. M. Antibiotic efficacy against Vibrio vulnificus in the mouse: superiority of tetracycline. J Pharmacol Exp Ther. 1983 Jun;225(3):595–598. [PubMed] [Google Scholar]
- Chalkley L. J., Koornhof H. J. Antimicrobial activity of ciprofloxacin against Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus determined by the killing curve method: antibiotic comparisons and synergistic interactions. Antimicrob Agents Chemother. 1985 Aug;28(2):331–342. doi: 10.1128/aac.28.2.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chang J. J., Sheen I. S., Peng S. M., Chen P. C., Wu C. S., Leu H. S. Vibrio vulnificus infection--report of 8 cases and review of cases in Taiwan. Changgeng Yi Xue Za Zhi. 1994 Dec;17(4):339–346. [PubMed] [Google Scholar]
- Chuang Y. C., Young C. D., Chen C. W. Vibrio vulnificus infection. Scand J Infect Dis. 1989;21(6):721–726. doi: 10.3109/00365548909021703. [DOI] [PubMed] [Google Scholar]
- Chuang Y. C., Yuan C. Y., Liu C. Y., Lan C. K., Huang A. H. Vibrio vulnificus infection in Taiwan: report of 28 cases and review of clinical manifestations and treatment. Clin Infect Dis. 1992 Aug;15(2):271–276. doi: 10.1093/clinids/15.2.271. [DOI] [PubMed] [Google Scholar]
- Fang F. C. Use of tetracycline for treatment of Vibrio vulnificus infections. Clin Infect Dis. 1992 Dec;15(6):1071–1072. doi: 10.1093/clind/15.6.1071. [DOI] [PubMed] [Google Scholar]
- French G. L., Woo M. L., Hui Y. W., Chan K. Y. Antimicrobial susceptibilities of halophilic vibrios. J Antimicrob Chemother. 1989 Aug;24(2):183–194. doi: 10.1093/jac/24.2.183. [DOI] [PubMed] [Google Scholar]
- Friedland I. R., Paris M., Shelton S., McCracken G. H. Time-kill studies of antibiotic combinations against penicillin-resistant and -susceptible Streptococcus pneumoniae. J Antimicrob Chemother. 1994 Aug;34(2):231–237. doi: 10.1093/jac/34.2.231. [DOI] [PubMed] [Google Scholar]
- Howard R. J., Pessa M. E., Brennaman B. H., Ramphal R. Necrotizing soft-tissue infections caused by marine vibrios. Surgery. 1985 Jul;98(1):126–130. [PubMed] [Google Scholar]
- Hsueh P. R., Chang J. C., Chang S. C., Ho S. W., Hsieh W. C. In vitro antimicrobial susceptibility of Vibrio vulnificus isolated in Taiwan. Eur J Clin Microbiol Infect Dis. 1995 Feb;14(2):151–153. doi: 10.1007/BF02111880. [DOI] [PubMed] [Google Scholar]
- JAWETZ E., GUNNISON J. B. An experimental basis of combined antibiotic action. J Am Med Assoc. 1952 Oct 18;150(7):693–695. doi: 10.1001/jama.1952.63680070011015. [DOI] [PubMed] [Google Scholar]
- Jenkins R. D., Johnston J. M. Inland presentation of Vibrio vulnificus primary septicemia and necrotizing fasciitis. West J Med. 1986 Jan;144(1):78–80. [PMC free article] [PubMed] [Google Scholar]
- Kelly M. T., Avery D. M. Lactose-positive Vibrio in seawater: a cause of pneumonia and septicemia in a drowning victim. J Clin Microbiol. 1980 Mar;11(3):278–280. doi: 10.1128/jcm.11.3.278-280.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Klontz K. C., Lieb S., Schreiber M., Janowski H. T., Baldy L. M., Gunn R. A. Syndromes of Vibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981-1987. Ann Intern Med. 1988 Aug 15;109(4):318–323. doi: 10.7326/0003-4819-109-4-318. [DOI] [PubMed] [Google Scholar]
- Morris J. G., Jr, Tenney J. Antibiotic therapy for Vibrio vulnificus infection. JAMA. 1985 Feb 22;253(8):1121–1122. [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]
- Rahal J. J., Jr Antibiotic combinations: the clinical relevance of synergy and antagonism. Medicine (Baltimore) 1978 Mar;57(2):179–195. [PubMed] [Google Scholar]
- Tacket C. O., Brenner F., Blake P. A. Clinical features and an epidemiological study of Vibrio vulnificus infections. J Infect Dis. 1984 Apr;149(4):558–561. doi: 10.1093/infdis/149.4.558. [DOI] [PubMed] [Google Scholar]
- Tyring S. K., Lee P. C. Hemorrhagic bullae associated with Vibrio vulnificus septicemia. Report of two cases. Arch Dermatol. 1986 Jul;122(7):818–820. [PubMed] [Google Scholar]
- Visalli M. A., Jacobs M. R., Appelbaum P. C. MIC and time-kill study of activities of DU-6859a, ciprofloxacin, levofloxacin, sparfloxacin, cefotaxime, imipenem, and vancomycin against nine penicillin-susceptible and -resistant pneumococci. Antimicrob Agents Chemother. 1996 Feb;40(2):362–366. doi: 10.1128/aac.40.2.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wongpaitoon V., Sathapatayavongs B., Prachaktam R., Bunyaratvej S., Kurathong S. Spontaneous Vibrio vulnificus peritonitis and primary sepsis in two patients with alcoholic cirrhosis. Am J Gastroenterol. 1985 Sep;80(9):706–708. [PubMed] [Google Scholar]
- Woo M. L., Patrick W. G., Simon M. T., French G. L. Necrotising fasciitis caused by Vibrio vulnificus. J Clin Pathol. 1984 Nov;37(11):1301–1304. doi: 10.1136/jcp.37.11.1301. [DOI] [PMC free article] [PubMed] [Google Scholar]