Abstract
Amoxicillin-clavulanic acid was compared with ampicillin-sulbactam in preventing the development of mixed infections produced in mice by subcutaneous inoculation of amoxicillin-resistant strains of Bacteroides fragilis and Escherichia coli. At doses designed to produce concentrations in mouse plasma similar to those obtained in humans, both amoxicillin-clavulanic acid and ampicillin-sulbactam were effective in preventing an infection caused by B. fragilis VPI 8908 mixed with E. coli E96, both strains being susceptible in vitro to each combination. However, ampicillin-sulbactam failed to arrest the progression of infections involving a more potent beta-lactamase-producing strain, E. coli 41548, even when a comparatively low inoculum was tested. In contrast, amoxicillin-clavulanic acid therapy effectively reduced the bacterial numbers at the site of infection. These data illustrate the need to treat polymicrobial infections with agents effective against the responsible aerobic as well as anaerobic bacteria.
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- Aronoff S. C., Jacobs M. R., Johenning S., Yamabe S. Comparative activities of the beta-lactamase inhibitors YTR 830, sodium clavulanate, and sulbactam combined with amoxicillin or ampicillin. Antimicrob Agents Chemother. 1984 Oct;26(4):580–582. doi: 10.1128/aac.26.4.580. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beale A. S., Gisby J., Sutherland R. Efficacy of amoxycillin/clavulanic acid in experimental Bacteroides fragilis/Escherichia coli mixed infections. J Antimicrob Chemother. 1988 Apr;21(4):451–459. doi: 10.1093/jac/21.4.451. [DOI] [PubMed] [Google Scholar]
- Boon R. J., Beale A. S., Comber K. R., Pierce C. V., Sutherland R. Distribution of amoxicillin and clavulanic acid in infected animals and efficacy against experimental infections. Antimicrob Agents Chemother. 1982 Sep;22(3):369–375. doi: 10.1128/aac.22.3.369. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Danziger L., Hassan E. Antimicrobial prophylaxis of gastrointestinal surgical procedures and treatment of intraabdominal infections. Drug Intell Clin Pharm. 1987 May;21(5):406–416. doi: 10.1177/106002808702100502. [DOI] [PubMed] [Google Scholar]
- Fisher J., Charnas R. L., Bradley S. M., Knowles J. R. Inactivation of the RTEM beta-lactamase from Escherichia coli. Interaction of penam sulfones with enzyme. Biochemistry. 1981 May 12;20(10):2726–2731. doi: 10.1021/bi00513a004. [DOI] [PubMed] [Google Scholar]
- Gutmann L., Kitzis M. D., Yamabe S., Acar J. F. Comparative evaluation of a new beta-lactamase inhibitor, YTR 830, combined with different beta-lactam antibiotics against bacteria harboring known beta-lactamases. Antimicrob Agents Chemother. 1986 May;29(5):955–957. doi: 10.1128/aac.29.5.955. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leigh D. A., Bradnock K., Marriner J. M. Augmentin (amoxycillin and clavulanic acid) therapy in complicated infections due to beta-lactamase producing bacteria. J Antimicrob Chemother. 1981 Mar;7(3):229–236. doi: 10.1093/jac/7.3.229. [DOI] [PubMed] [Google Scholar]
- Matsuura M., Nakazawa H., Hashimoto T., Mitsuhashi S. Combined antibacterial activity of amoxicillin with clavulanic acid against ampicillin-resistant strains. Antimicrob Agents Chemother. 1980 Jun;17(6):908–911. doi: 10.1128/aac.17.6.908. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rees E. The treatment of pelvic inflammatory disease. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):1042–1047. doi: 10.1016/0002-9378(80)91105-9. [DOI] [PubMed] [Google Scholar]
- Sanz Sanz F., Del Palacio Hernanz A., Amor Sánchez E., Gómez Alvárez C., Noriega A. R. Double-blind randomized comparative trial: ornidazole (Tiberal) versus tinidazole (Fasigin) for the treatment of non-specific vaginitis. Chemioterapia. 1985 Jun;4(3):218–221. [PubMed] [Google Scholar]
- Stevenson C. S., Sterne G. S., Stephens K. O. Liability for infectious diseases in day care: legal and practical considerations. Rev Infect Dis. 1986 Jul-Aug;8(4):644–647. doi: 10.1093/clinids/8.4.644. [DOI] [PubMed] [Google Scholar]
- Wise R., Andrews J. M., Bedford K. A. Clavulanic acid and CP-45,899: a comparison of their in vitro activity in combination with penicillins. J Antimicrob Chemother. 1980 Mar;6(2):197–206. doi: 10.1093/jac/6.2.197. [DOI] [PubMed] [Google Scholar]