Comparative in vitro activity of piperacillin/tazobactam against gram-negative bacilli

L D Liebowitz, K P Klugman
South African Medical Journal 1996, 86 (10): 1276-80

OBJECTIVE: To describe the in vitro activity of piperacillin/tazobactam against clinical isolates of Gram-negative bacteria, compared with other antibacterial agents.

DESIGN: Survey of susceptibility of clinical isolates of Gram-negative bacilli.

SETTING: Academic hospitals of the University isolates of the Witwatersrand teaching complex. BACTERIAL STRAINS: 180 selected clinical isolates of Gram-negative bacilli.

MAIN OUTCOME MEASURES: Minimum inhibitory concentrations (MICs) determined by agar dilution using techniques according to the recommendations of the National Committee for Clinical Laboratory Standards.

RESULTS: Ciprofloxacin, biapenerm, imipenem, cefepime and cefpirome were all highly active against most of the Enterobacteriaceae. All the ampicillin-resistant strains of Enterobacteriaceae were susceptible to piperacillin/tazobactam, MIC90 values being 4/4 mg/l for Klebsiella and Proteus/Providencia spp., 8/4 mg/l for Citrobacter and Serratia spp., and 16/4 mg/l for Escherichia coli. All the agents, with the exception of ampicillin (MIC90 4 mg/l) and chloramphenicol (MIC90 4 mg/l), were highly active against the Haemophilus influenzae isolates tested. All Bacteroides fragilis strains were susceptible to piperacillin/tazobactam (MIC90 8/4 mg/l), as well as to co-amoxiclav (MIC90 4/2 mg/l), biapenem and imipenem (MIC90s 0.5 mg/l). The Pseudomonas spp. tested included strains resistant to piperacillin/tazobactam, ceftazidime, biapenem, gentamicin, tobramycin and ciprofloxacin. Cefepime was the most active agent against Pseudomonas isolates, with 90% of the strains being susceptible to this agent, while biapenem was the most active agent against the Acinetobacter isolates investigated.

CONCLUSIONS: The in vitro spectrum of activity of piperacillin/tazobactam against the majority of isolates was comparable to those of the other new agents tested.

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