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. Author manuscript; available in PMC: 2014 Aug 1.

Published in final edited form as: J Surg Res. 2013 Feb 24;183(2):767–776. doi: 10.1016/j.jss.2013.02.003

We observed a difference in effect of early administration of azithromycin with subsequent ciprofloxacin or tobramycin on P. aeruginosa infection at the skin. A trend toward additive antimicrobial effect with ciprofloxacin was noted while apparent antagonism with tobramycin was observed. Significantly greater bacteria were cultured from the wound when azithromycin preceded tobramycin administration compared with tobramycin administration alone (Figure 4a; #P<0.01, N=8–10 from 3 replicate experiments).

Early administration of azithromycin appeared to increase bacterial spread to the lung in animals treated with tobramycin compared with tobramycin alone (*P<0.02, N=12–15). This was not observed with azithromycin and ciprofloxacin where the combination resulted in a reduction in lung bacterial density that was not statistically significant compared to ciprofloxacin alone. Splenic P. aeruginosa growth showed similar trends but was relatively low in all antibiotic treatment groups and no significant differences were observed (data not shown).

We observed a difference in effect of early administration of azithromycin with subsequent ciprofloxacin or tobramycin on P. aeruginosa infection at the skin. A trend toward additive antimicrobial effect with ciprofloxacin was noted while apparent antagonism with tobramycin was observed. Significantly greater bacteria were cultured from the wound when azithromycin preceded tobramycin administration compared with tobramycin administration alone (Figure 4a; #P<0.01, N=8–10 from 3 replicate experiments).

Early administration of azithromycin appeared to increase bacterial spread to the lung in animals treated with tobramycin compared with tobramycin alone (*P<0.02, N=12–15). This was not observed with azithromycin and ciprofloxacin where the combination resulted in a reduction in lung bacterial density that was not statistically significant compared to ciprofloxacin alone. Splenic P. aeruginosa growth showed similar trends but was relatively low in all antibiotic treatment groups and no significant differences were observed (data not shown).