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    Title: Appropriate composites of cefoperazone-sulbactam against multidrug-resistant organisms
    Authors: Lai, Chih-Cheng
    Chen, Chi-Chung
    Lu, Ying-Chen
    Lin, Tsuey-Pin
    Chuang, Yin-Ching
    Tang, Hung-Jen
    Contributors: Chi Mei Med Ctr, Dept Intens Care Med
    Chi Mei Med Ctr, Dept Med Res
    Natl Chiayi Univ, Dept Food Sci
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chi Mei Med Ctr, Dept Internal Med
    Chi Mei Med Ctr, Dept Med
    Keywords: cefoperazone-sulbactam
    extended-spectrum beta-lactamases
    Escherichia coli
    Klebsiella pneumoniae
    multidrug-resistant organisms
    Date: 2018
    Issue Date: 2019-11-15 15:43:53 (UTC+8)
    Abstract: Objectives: This study aims to assess the in vitro activity of different cefoperazone-sulbactam ratios against different multidrug-resistant organisms (MDROs). Materials and methods: Minimum inhibitory concentrations (MICs) and susceptibility rates of cefoperazone, sulbactam and cefoperazone-sulbactam at fixed ratios of 2:1, 1:1 and 1:2 against 344 MDRO clinical isolates, including extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (n=58), ESBL-producing Klebsiella pneumoniae (n=58), carbapenem-resistant Enterobacteriaceae (n=57), carbapenem-resistant Pseudomonas aeruginosa (n=49) and carbapenem-resistant Acinetobacter baumannii (n=122), were measured. Results: Combined treatment with sulbactam and cefoperazone resulted in decreased MIC50 values across all MDROs, as well as decreases in most MIC90 values, except for carbapenem-resistant Enterobacteriaceae and carbapenem-resistant P. aeruginosa (MIC90 values remained >64 mg/L). Susceptibility rates of treatment with cefoperazone alone against all MDROs were much lower than that of cefoperazone-sulbactam combination (all P<0.05), except in carbapenem-resistant P. aeruginosa. Additionally, the susceptibility rate gradually increased as the ratio of cefoperazone-sulbactam was adjusted from 2:1 to 1:1 and to 1:2 for carbapenem-resistant Enterobacteriaceae, ESBL-producing K. pneumoniae and carbapenem-resistant A. baumannii. There were no significant ratio-dependent changes in susceptibility rates with cefoperazone-sulbactam in carbapenem-resistant P. aeruginosa. Conclusion: Adding sulbactam enhances cefoperazone activity against most MDROs excluding carbapenem-resistant P. aeruginosa, and the activity of cefoperazone-sulbactam against these MDROs is greatest at a ratio of 1: 2, followed by ratios of 1:1 and 2:1.
    Relation: Infection and Drug Resistance, v.11, pp.1441-1445
    Appears in Collections:[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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