piperacillin--tazobactam-drug-combination and Otitis-Media--Suppurative

A drug susceptibility test of the combination drug TAZ/PIPC, which consists of a newly developed beta-lactamase inhibitor, tazobactam (TAZ), and one of penicillin antibiotics, piperacillin (PIPC), with combination ratio of 1:4 in potency, was conducted with stock strains and clinical isolates. The clinical efficacy and safety of its injection was also evaluated in children with a variety of infectious diseases. The results were as follows: 1. In susceptibility test, 114 strains from 4 species of stock strains were treated with 8 drugs, that is, TAZ/PIPC, PIPC, penicillin G (PCG), ampicillin (ABPC), cefotiam (CTM), cefotaxime (CTX), ceftazidime (CAZ), and sulbactam/cefoperazone (SBT/CPZ). Of three clinically isolated species from patients, Staphylococcus aureus (S. aureus) was treated with TAZ/PIPC, PIPC, methicillin (DMPPC), CTM, CTX, and SBT/CPZ, and the others were treated with the same drugs except for DMPPC. The MICs were measured for these bacterial strains inoculated at the concentration of 10(6) CFU/ml. The MIC90 values of TAZ/PIPC against 45 strains of Streptococcus pyogenes (S. pyogenes), one of the stock cultures of Gram-positive cocci, were 0.05 microgram/ml and similar to those of PIPC, CTM, CAZ, and SBT/CPZ. The MICs of TAZ/PIPC for 28 strains of Streptococcus agalactiae (S. agalactiae) were 0.39 microgram/ml and similar to those of PIPC, CTM, CAZ, and SBT/CPZ. As for Gram-negative bacilli, the MIC90 of TAZ/PIPC against 10 strains of Bordetella pertussis (B. pertussis) were 0.10 microgram/ml and similar to those of PIPC. The MIC90 of TAZ/PIPC against 31 strains of Haemophilus influenzae (H. influenzae) were 0.05 microgram/ml and similar to those of PIPC, CTX, and SBT/CPZ. Regarding Gram-positive cocci isolated from patients received this combination drug, the MIC90 of TAZ/PIPC against 2 strains of S. aureus, a non beta-lactamase producing strain and a low-beta-lactamase producing strain, were 0.78 microgram/ml and 3.1 micrograms/ml, respectively; the former value was similar to those of PIPC, DMPPC, CTM, and CTX, and the latter was similar to those of PIPC, DMPPC, CTX, and SBT/CPZ. Of 4 strains of Streptococcus pneumoniae, 2 strains were inhibited at 0.05 microgram/ml, and the others at 1.56 micrograms/ml; both values were similar to those of PIPC, SBT/CPZ. As for Gram-negative bacilli, 6 of 7 strains of H. influenzae did not produce beta-lactamase and 1 strain was a high producer. The MICs of TAZ/PIPC against beta-lactamase nonproducing stra

Topics: Acute Disease; Bacterial Infections; beta-Lactamase Inhibitors; Bordetella pertussis; Bronchitis; Child; Child, Preschool; Drug Therapy, Combination; Female; Haemophilus influenzae; Humans; Infant; Lymphadenitis; Male; Otitis Media, Suppurative; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia, Bacterial; Staphylococcus aureus; Streptococcus agalactiae; Streptococcus pneumoniae; Streptococcus pyogenes; Urinary Tract Infections; Whooping Cough

Bacterial biofilm formation has been implicated in the high rate of persistent otorrhea after tympanostomy tube insertion. It has been suggested that the tube material may be an important factor in the development of otorrhea. Recently we reported the presence of ciprofloxacin-resistant Pseudomonas aeruginosa (CRPA) biofilms on infected tympanostomy tubes following the use of intractable post-tympanostomy tubes and the onset of otorrhea. In this study, we have evaluated the resistance of piperacillin-tazobactam coated with chitosan on a tympanostomy tube to prevent CRPA biofilm formation in vitro.. Three sets each of piperacillin-tazobactam coated silicone tubes (n=5), commercial silver-oxide coated silicone tubes (Activent, Silic) (n=5) and control uncoated tympanostomy tubes (Paparella type 1) (n=5) were processed for evaluation. The piperacillin-tazobactam coated tympanostomy tubes were compared with the silver-oxide coated tubes and the uncoated control tubes for resistance to CRPA biofilm formation after in vitro incubation.. Scanning electron microscopy showed that the surface of the silver-oxide coated tube (Activent) formed a thick biofilm with crusts as well as an uncoated tube. In contrast, the surface of a piperacillin-tazobactam coated tympanostomy tube showed virtually no CRPA biofilm formation.. The piperacillin-tazobactam coated tympanostomy tube showed resistance to CRPA biofilm formation. The piperacillin-tazobactam coating may be useful to reduce CRPA biofilm formation; however, further in vivo studies are necessary.

Topics: Anti-Bacterial Agents; Bacterial Adhesion; Bacteriological Techniques; Biofilms; Ciprofloxacin; Coated Materials, Biocompatible; Drug Resistance, Bacterial; Equipment Contamination; Equipment Design; Humans; Materials Testing; Microscopy, Electron, Scanning; Middle Ear Ventilation; Otitis Media, Suppurative; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Prosthesis-Related Infections; Pseudomonas aeruginosa; Pseudomonas Infections; Silicones; Surface Properties