azlocillin and Streptococcal-Infections

In-vitro and clinical efficacy of a combination therapy consisting of 3 antibiotic agents was to be assessed in neonatal septicemia.. From 1980 to 1987, 152 newborns with septicemia as proven by blood culture were treated with an initial antibiotic regimen consisting of azlocillin (150 mg/kg bw), cefotaxime (100 mg/kg bw), and tobramycin (5 mg/kg bw).. According to the microbiologic testing, antimicrobic therapy was effective in each of the 152 organisms: 101/152 bacteria were susceptible to all 3 agents; resistance to 1 or 2 of the antibiotics was evident in 33/152 and in 18/152 organisms, respectively. Mortality due to septicemia was 7.2%.. As no difference was observed in the frequency in which one of the three antibiotic substances was the only effective drug, each of the 3 agents seemed to be necessary for clinical effectiveness of this antibiotic combination.

Topics: Azlocillin; Bacteriological Techniques; Cefotaxime; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Microbial Sensitivity Tests; Risk Factors; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptococcus agalactiae; Tobramycin

Closed-space neutropenic infection sites were simulated in rabbits by subcutaneous semipermeable chambers that were inoculated with 5 X 10(4) CFU/ml of various strains of Streptococcus pneumoniae, Streptococcus faecalis, and Streptococcus avium. Four hours after inoculation, treatment was begun with ciprofloxacin, 10 or 30 mg/kg, azlocillin, 100 mg/kg, amikacin, 15 mg/kg, procaine penicillin G, 300 U/dose, or gentamicin, 2 mg/kg, alone and in two-drug combinations. Antimicrobials were given intramuscularly every 6 hr for 16 doses. Extravascular chambers were sampled throughout the treatment course for bacterial counts and antimicrobial concentration. In vivo results were compared to in vitro tests of inhibition, killing, and synergism. Ciprofloxacin alone had little effect on the animal infection sites. Azlocillin alone reduced, in vivo, eight of 12 isolates greater than or equal to 5 log10 CFU/ml by 92 hr as compared to control. Azlocillin plus ciprofloxacin reduced all 12 isolates greater than or equal to 5 log10 CFU/ml by 92 hr, whereas amikacin plus azlocillin reduced only three and penicillin plus gentamicin only one of the six group D streptococcal isolates greater than or equal to 5 log10 CFU/ml.

Topics: Amikacin; Animals; Azlocillin; Ciprofloxacin; Disease Models, Animal; Drug Synergism; Drug Therapy, Combination; Enterococcus faecalis; Female; Gentamicins; Kinetics; Neutropenia; Penicillin G; Rabbits; Streptococcal Infections; Streptococcus; Streptococcus pneumoniae

The susceptibility of enterococci to 16 beta-lactam antibiotics (5 penicillins, 11 cephalosporins) was evaluated by determining MICs. All cephalosporins are ineffective against these bacteria. Penicillin G should not be used to treat infections with enterococci. For less serious infections due to enterococci, ampicillin is certainly the drug of first choice. Azlocillin, mezlocillin and piperacillin are the most effective drugs to prevent superinfections with enterococci in clinically and bacteriologically defined situations.

Topics: Anti-Bacterial Agents; Azlocillin; Cephalosporins; Enterococcus faecalis; Humans; Microbial Sensitivity Tests; Penicillins; Streptococcal Infections