Abstract
The effect of gentamicin against 130 clinical isolates of Pseudomonas aeruginosa was compared with that of two investigational aminoglycoside antibiotics, tobramycin and amikacin. Minimal inhibitory concentration data indicated that, on a weight basis, tobramycin was two to four times as active as gentamicin against most isolates. However, 14 of 18 organisms highly resistant to gentamicin (≥80 μg/ml) were also highly resistant to tobramycin. Amikacin was the least active aminoglycoside on a weight basis, but none of the isolates were highly resistant to this antibiotic. When therapeutically achievable concentrations were used, adding carbenicillin to gentamicin or to tobramycin enhanced inhibitory activity against those isolates susceptible (≤5 μg/ml) or moderately resistant (10 to 40 μg/ml) to the aminoglycoside. Such synergy was seldom demonstrated for isolates highly resistant to gentamicin or tobramycin. The combination of carbenicillin and amikacin enhanced inhibition against all but two of the isolates. Both tobramycin and amikacin offer in vitro advantages over gentamicin against P. aeruginosa.
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Selected References
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- Andriole V. T. Synergy of carbenicillin and gentamicin in experimental infection with Pseudomonas. J Infect Dis. 1971 Dec;124 (Suppl):S46–S55. doi: 10.1093/infdis/124.supplement_1.s46. [DOI] [PubMed] [Google Scholar]
- Brumfitt W., Percival A., Leigh D. A. Clinical and laboratory studies with carbenicillin. A new penicillin active against Pseudomonas pyocyanea. Lancet. 1967 Jun 17;1(7503):1289–1293. doi: 10.1016/s0140-6736(67)91590-5. [DOI] [PubMed] [Google Scholar]
- Brusch J. L., Barza M., Bergeron M. G., Weinstein L. Cross-resistance of Pseudomonas to gentamicin and tobramycin. Antimicrob Agents Chemother. 1972 Mar;1(3):280–281. doi: 10.1128/aac.1.3.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Clarke J. T., Libke R. D., Regamey C., Kirby W. M. Comparative pharmacokinetics of amikacin and kanamycin. Clin Pharmacol Ther. 1974 Jun;15(6):610–616. doi: 10.1002/cpt1974156610. [DOI] [PubMed] [Google Scholar]
- Crowe C. C., Sanders E. Is there complete cross-resistance of gram-negative bacilli to gentamicin and tobramycin? Antimicrob Agents Chemother. 1972 Nov;2(5):415–416. doi: 10.1128/aac.2.5.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Darrell J. H., Waterworth P. M. Carbenicillin resistance in Pseudomonas aeruginosa from clinical material. Br Med J. 1969 Jul 19;3(5663):141–143. doi: 10.1136/bmj.3.5663.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Del Bene V. E., Farrar W. E., Jr Tobramycin: in vitro activity and comparison with kanamycin and gentamicin. Antimicrob Agents Chemother. 1972 Apr;1(4):340–342. doi: 10.1128/aac.1.4.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gordon R. C., Regamey C., Kirby W. M. Serum protein binding of the aminoglycoside antibiotics. Antimicrob Agents Chemother. 1972 Sep;2(3):214–216. doi: 10.1128/aac.2.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greene W. H., Moody M., Schimpff S., Young V. M., Wiernik P. H. Pseudomonas aeruginosa resistant to carbenicillin and gentamicin. Epidemiologic and clinical aspects in a cancer center. Ann Intern Med. 1973 Nov;79(5):684–689. doi: 10.7326/0003-4819-79-5-684. [DOI] [PubMed] [Google Scholar]
- Jordan M. C., Standiford H. C., Kirby W. M. Carbenicillin in treatment of severe infections due to pseudomonas. J Infect Dis. 1970 Sep;122(Suppl):S96+–S96+. doi: 10.1093/infdis/122.supplement_1.s96. [DOI] [PubMed] [Google Scholar]
- Klastersky J., Cappel R., Daneau D. Therapy with carbenicillin and gentamicin for patients with cancer and severe infections caused by gram-negative rods. Cancer. 1973 Feb;31(2):331–336. doi: 10.1002/1097-0142(197302)31:2<331::aid-cncr2820310210>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
- Konícková L., Prát V. Effect of carbenicillin, gentamicin, and their combination on experimental Pseudomonas aeruginosa urinary tract infection. J Clin Pathol. 1971 Mar;24(2):113–116. doi: 10.1136/jcp.24.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lowbury E. J., Lilly H. A., Kidson A., Ayliffe G. A., Jones R. J. Sensitivity of Pseudomonas aeruginosa to antibiotics: emergence of strains highly resistant to carbenicillin. Lancet. 1969 Aug 30;2(7618):448–452. doi: 10.1016/s0140-6736(69)90163-9. [DOI] [PubMed] [Google Scholar]
- Phair J. P., Watanakunakorn C., Bannister T. In vitro susceptibility of Pseudomonas aeruginosa to carbenicillin and the combination of carbenicillin and gentamicin. Appl Microbiol. 1969 Sep;18(3):303–306. doi: 10.1128/am.18.3.303-306.1969. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Price K. E., Chisholm D. R., Misiek M., Leitner F., Tsai Y. H. Microbiological evaluation of BB-K 8, a new semisynthetic aminoglycoside. J Antibiot (Tokyo) 1972 Dec;25(12):709–731. doi: 10.7164/antibiotics.25.709. [DOI] [PubMed] [Google Scholar]
- Reed S. E. The interaction of mycoplasmas and influenza viruses in tracheal organ cultures. J Infect Dis. 1971 Jul;124(1):18–25. doi: 10.1093/infdis/124.1.18. [DOI] [PubMed] [Google Scholar]
- Regamey C., Gordon R. C., Kirby W. M. Comparative pharmacokinetics of tobramycin and gentamicin. Clin Pharmacol Ther. 1973 May-Jun;14(3):396–403. doi: 10.1002/cpt1973143396. [DOI] [PubMed] [Google Scholar]
- Smith C. B., Dans P. E., Wilfert J. N., Finland M. Use of gentamicin in combinations with other antibiotics. J Infect Dis. 1969 Apr-May;119(4):370–377. doi: 10.1093/infdis/119.4-5.370. [DOI] [PubMed] [Google Scholar]
- Sonne M., Jawetz E. Combined action of carbenicillin and gentamicin on Pseudomonas aeruginosa in vitro. Appl Microbiol. 1969 Jun;17(6):893–896. doi: 10.1128/am.17.6.893-896.1969. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stone H. H., Kolb L. D. The evolution and spread of gentamicin-resistant Pseudomonads. J Trauma. 1971 Jul;11(7):586–589. doi: 10.1097/00005373-197107000-00009. [DOI] [PubMed] [Google Scholar]