Skip to main content
PMC home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1992 Dec;36(12):2634–2638. doi: 10.1128/aac.36.12.2634

In vitro susceptibilities of Actinobacillus actinomycetemcomitans to a number of antimicrobial combinations.

M J Pavicić 1, A J van Winkelhoff 1, J de Graaff 1
PMCID: PMC245519  PMID: 1482130

Abstract

The in vitro susceptibilities of Actinobacillus actinomycetemcomitans to 14 antimicrobial combinations were studied by using the checkerboard titration technique. The results, expressed as the range of the fractional inhibitory concentration indices, were as follows: for metronidazole or its hydroxymetabolite combined with cefixime, 0.2 to 0.6; for moxalactam, 0.2 to 0.6; for penicillin G, 0.3 to 0.6; for tobramycin, 0.8 to 2.0; for erythromycin, 0.8 to 1.7; for ciprofloxacin, 0.2 to 0.6; for tetracycline, 0.8 to 1.2. Our observations indicated that the beta-lactam antibiotics as well as ciprofloxacin act synergistically with both metronidazole and its hydroxymetabolite against A. actinomycetemcomitans. Synergistic interactions were independent of the individual MICs of the antibiotics tested. Erythromycin, tobramycin, and tetracycline combined with either metronidazole or its hydroxymetabolite showed additive to indifferent effects against the five strains of A. actinomycetemcomitans, with the fractional inhibitory concentration indices ranging from 0.8 to 2.0. A. actinomycetemcomitans was found to be highly susceptible to ciprofloxacin (MIC of ciprofloxacin for 90% of strains tested, 0.010 micrograms/ml) and cefixime (MIC of cefixime for 90% of strains tested, 0.8 micrograms/ml). The results indicate that in patients who are allergic to penicillin, cefixime and ciprofloxacin may be useful alternative antibiotics in combination with metronidazole for the treatment of A. actinomycetemcomitans-associated periodontitis.

Full text

PDF
2634

Selected References

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

  1. Anderson J. A. Cross-sensitivity to cephalosporins in patients allergic to penicillin. Pediatr Infect Dis. 1986 Sep-Oct;5(5):557–561. doi: 10.1097/00006454-198609000-00013. [DOI] [PubMed] [Google Scholar]
  2. Berenbaum M. C. A method for testing for synergy with any number of agents. J Infect Dis. 1978 Feb;137(2):122–130. doi: 10.1093/infdis/137.2.122. [DOI] [PubMed] [Google Scholar]
  3. Cirau-Vigneron N., Barrier J., Becue J., Chartier M., Giraud J. R., Landes P., Leng J., Raudrant D., Reme J. M. Amoxycillin/clavulanic acid ('Augmentin') compared with a combination of aminopenicillin, aminoglycoside and metronidazole in the treatment of pelvic inflammatory disease. Pharmatherapeutica. 1989;5(5):312–319. [PubMed] [Google Scholar]
  4. Drlica K., Franco R. J. Inhibitors of DNA topoisomerases. Biochemistry. 1988 Apr 5;27(7):2253–2259. doi: 10.1021/bi00407a001. [DOI] [PubMed] [Google Scholar]
  5. Grace C. J., Levitz R. E., Katz-Pollak H., Brettman L. R. Actinobacillus actinomycetemcomitans prosthetic valve endocarditis. Rev Infect Dis. 1988 Sep-Oct;10(5):922–929. doi: 10.1093/clinids/10.5.922. [DOI] [PubMed] [Google Scholar]
  6. Gulaid A., Houghton G. W., Lewellen O. R., Smith J., Thorne P. S. Determination of metronidazole and its two major metabolites in biological fluids by high pressure liquid chromatography. Br J Clin Pharmacol. 1978 Nov;6(5):430–432. doi: 10.1111/j.1365-2125.1978.tb04608.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Haffajee A. D., Dzink J. L., Socransky S. S. Effect of modified Widman flap surgery and systemic tetracycline on the subgingival microbiota of periodontal lesions. J Clin Periodontol. 1988 Apr;15(4):255–262. doi: 10.1111/j.1600-051x.1988.tb01579.x. [DOI] [PubMed] [Google Scholar]
  8. Jousimies-Somer H., Asikainen S., Suomala P., Summanen P. Activity of metronidazole and its hydroxy metabolite against clinical isolates of Actinobacillus actinomycetemcomitans. Oral Microbiol Immunol. 1988 Mar;3(1):32–34. doi: 10.1111/j.1399-302x.1988.tb00602.x. [DOI] [PubMed] [Google Scholar]
  9. Kaplan A. H., Weber D. J., Oddone E. Z., Perfect J. R. Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis. 1989 Jan-Feb;11(1):46–63. doi: 10.1093/clinids/11.1.46. [DOI] [PubMed] [Google Scholar]
  10. Kristinsson K. G., Thorgeirsson G., Holbrook W. P. Actinobacillus actinomycetemcomitans and endocarditis. J Infect Dis. 1988 Mar;157(3):599–599. doi: 10.1093/infdis/157.3.599. [DOI] [PubMed] [Google Scholar]
  11. Mandell R. L., Socransky S. S. Microbiological and clinical effects of surgery plus doxycycline on juvenile periodontitis. J Periodontol. 1988 Jun;59(6):373–379. doi: 10.1902/jop.1988.59.6.373. [DOI] [PubMed] [Google Scholar]
  12. Norrby S. R. Treatment failures with broad-spectrum antibiotics. Scand J Infect Dis Suppl. 1991;78:64–70. [PubMed] [Google Scholar]
  13. O'Riordan T., Mathai E., Tobin E., McKenna D., Keane C., Sweeney E., O'Morain C. Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate. Gut. 1990 Sep;31(9):999–1002. doi: 10.1136/gut.31.9.999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pavicić M. J., van Winkelhoff A. J., de Graaff J. Synergistic effects between amoxicillin, metronidazole, and the hydroxymetabolite of metronidazole against Actinobacillus actinomycetemcomitans. Antimicrob Agents Chemother. 1991 May;35(5):961–966. doi: 10.1128/aac.35.5.961. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Pierce C. S., Bartholomew W. R., Amsterdam D., Neter E., Zambon J. J. Endocarditis due to Actinobacillus actinomycetemcomitans serotype c and patient immune response. J Infect Dis. 1984 Mar;149(3):479–479. doi: 10.1093/infdis/149.3.479. [DOI] [PubMed] [Google Scholar]
  16. Rauws E. A., Tytgat G. N. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990 May 26;335(8700):1233–1235. doi: 10.1016/0140-6736(90)91301-p. [DOI] [PubMed] [Google Scholar]
  17. Renvert S., Wikström M., Dahlén G., Slots J., Egelberg J. On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets. J Clin Periodontol. 1990 Jul;17(6):351–355. doi: 10.1111/j.1600-051x.1990.tb00030.x. [DOI] [PubMed] [Google Scholar]
  18. Rodenburg J. P., van Winkelhoff A. J., Winkel E. G., Goené R. J., Abbas F., de Graff J. Occurrence of Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in severe periodontitis in relation to age and treatment history. J Clin Periodontol. 1990 Jul;17(6):392–399. doi: 10.1111/j.1600-051x.1990.tb00036.x. [DOI] [PubMed] [Google Scholar]
  19. Rosling B. G., Slots J., Webber R. L., Christersson L. A., Genco R. J. Microbiological and clinical effects of topical subgingival antimicrobial treatment on human periodontal disease. J Clin Periodontol. 1983 Sep;10(5):487–514. doi: 10.1111/j.1600-051x.1983.tb02180.x. [DOI] [PubMed] [Google Scholar]
  20. Slots J., Bragd L., Wikström M., Dahlén G. The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius in destructive periodontal disease in adults. J Clin Periodontol. 1986 Jul;13(6):570–577. doi: 10.1111/j.1600-051x.1986.tb00849.x. [DOI] [PubMed] [Google Scholar]
  21. Slots J. Enzymatic characterization of some oral and nonoral gram-negative bacteria with the API ZYM system. J Clin Microbiol. 1981 Sep;14(3):288–294. doi: 10.1128/jcm.14.3.288-294.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Slots J., Genco R. J. Black-pigmented Bacteroides species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans in human periodontal disease: virulence factors in colonization, survival, and tissue destruction. J Dent Res. 1984 Mar;63(3):412–421. doi: 10.1177/00220345840630031101. [DOI] [PubMed] [Google Scholar]
  23. Slots J., Rams T. E. Antibiotics in periodontal therapy: advantages and disadvantages. J Clin Periodontol. 1990 Aug;17(7 ):479–493. doi: 10.1111/j.1365-2710.1992.tb01220.x. [DOI] [PubMed] [Google Scholar]
  24. Slots J., Rosling B. G. Suppression of the periodontopathic microflora in localized juvenile periodontitis by systemic tetracycline. J Clin Periodontol. 1983 Sep;10(5):465–486. doi: 10.1111/j.1600-051x.1983.tb02179.x. [DOI] [PubMed] [Google Scholar]
  25. Slots J. Selective medium for isolation of Actinobacillus actinomycetemcomitans. J Clin Microbiol. 1982 Apr;15(4):606–609. doi: 10.1128/jcm.15.4.606-609.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Syed S. A., Loesche W. J. Survival of human dental plaque flora in various transport media. Appl Microbiol. 1972 Oct;24(4):638–644. doi: 10.1128/am.24.4.638-644.1972. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Zambon J. J. Actinobacillus actinomycetemcomitans in human periodontal disease. J Clin Periodontol. 1985 Jan;12(1):1–20. doi: 10.1111/j.1600-051x.1985.tb01348.x. [DOI] [PubMed] [Google Scholar]
  28. de Graaff J., van Winkelhoff A. J., Goené R. J. The role of Actinobacillus actinomycetemcomitans in periodontal disease. Infection. 1989 Jul-Aug;17(4):269–271. doi: 10.1007/BF01639538. [DOI] [PubMed] [Google Scholar]
  29. van Winkelhoff A. J., Rodenburg J. P., Goené R. J., Abbas F., Winkel E. G., de Graaff J. Metronidazole plus amoxycillin in the treatment of Actinobacillus actinomycetemcomitans associated periodontitis. J Clin Periodontol. 1989 Feb;16(2):128–131. doi: 10.1111/j.1600-051x.1989.tb01626.x. [DOI] [PubMed] [Google Scholar]
  30. van Winkelhoff A. J., Tijhof C. J., de Graaff J. Microbiological and clinical results of metronidazole plus amoxicillin therapy in Actinobacillus actinomycetemcomitans-associated periodontitis. J Periodontol. 1992 Jan;63(1):52–57. doi: 10.1902/jop.1992.63.1.52. [DOI] [PubMed] [Google Scholar]

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

RESOURCES