COLISTIN-CARBAPENEM COMBINATION THERAPY AGAINST CARBAPENEM RESISTANT GRAM NEGATIVE BACILLI INFECTIONS: CLINICAL AND AN IN VITRO SYNERGY STUDY
Journal Title: International Journal of Pharmacy and Pharmaceutical Sciences - Year 2014, Vol 6, Issue 10
Abstract
Objective: Combination therapy is recommended for carbapenem resistant Gram negative bacilli (CR GNB) infections. However, limited data exists on the clinical effectiveness of antibiotic combinations. The purpose of this study was to evaluate the efficacy of colistin-carbapenem combination against CR GNB infection in a clinical study and an in vitro synergy study using Etest.Methods: A study was conducted in a tertiary care hospital to evaluate the clinical outcome of patients with CR GNB infections who were treated with colistin-carbapenemcombination between January to April, 2013. It was comprised of 33 patients with CR GNB infection. Detection of in vitro synergy was performed by Etest for colistin-meropenem combination on five isolates. These isolates were also screened for the resistant genes blaOXA-23, blaVIMand blaNDM using single target PCR.Results: 33 CR GNB included Acinetobacterspp. (19), Pseudomonas aeruginosa (7) and Enterobacteriaceae spp. (7). Overall clinical success of 60.6% was observed in patients receiving colistin-carbapenem combination therapy. In respiratory infection, the clinical success rate was only 25%, whereas in soft tissue infection it was 57.1%. In bloodstream infection 100%  clinical success was observed. All five isolates screened using PCR was carrying bla NDM gene, whereas isolate of Acinetobacter baumannii also carried blaOXA-23 and blaVIM gene. Indifferent interactions were observed between colistin and meropenem against all five isolates.Conclusion: We observed low clinical success rate for colistin-carbapenem combination therapy, probably due to indifferent interactions between colistin and meropenem against NDM producing strain. In addition, probable pharmacokinetic concern of colistin may have a role to play.Keywords: Carbapenem resistance, Etest, New Delhi metallo-β-lactamases, Synergy.Â
Authors and Affiliations
Pooja Girish Shah, Sweta Ritesh Shah, Sheela D Kamat, Dileep V Kamat
Keywords
Related Articles
- EP ID EP579492
- DOI -
- Views 37
- Downloads 0
SYNTHESIS AND ASSESSMENT OF HEPATOPROTECITVE ACTIVITY OF SOME NEW 2-ARYL TETRAHYDROQUINOLINE AND SPIROOXYINDOLYL TETRAHYDROQUINOLINE DERIVATIVES
Objective: To evaluate the hepatoprotecitve potential of some newly synthesized tetrahydroquinoline derivatives against carbon tetrachloride induced hepatic damage in wister rats.Methods: A series of 2-aryl, 4-N vinyl py...
TERMINALIA CHEBULA: AN EPHEMERAL GLANCE
Herbal drugs represent a major allocation of all the recognized systems of health in the world. Also, the medicinal plants have been regarded as valuable and cheap sources of various phytoconstituents which are used exte...
HPLC-PDA METHOD FOR THE QUANTIFICATION OF PARACETAMOL IN PLASMA: APPLICATION TO PK/PD STUDIES WITH ARTHRITIC RATS
Objective: To develop and validate an easy, rapid, sensitive and selective high-performance liquid chromatography with photodiode diode-array (HPLC-PDA) detection method for quantification of paracetamol and to demonstra...
ADVANCED AMPLITUDE CENTERING AS AN INVIGORATING MANIPULATION FOR UNIFIED WAVELENGTH SPECTRAL RESOLUTION OF TERNARY MIXTURES
Objective: This work presented the novel spectrophotometric approach namely, advanced amplitude centering (AAC). The method was applied for the resolution of ternary mixtures with partially or completely overlapped spect...
DEVELOPMENT OF NEW PYRAZOLE HYBRIDS AS ANTITUBERCULAR AGENTS: SYNTHESIS, BIOLOGICAL EVALUATION AND MOLECULAR DOCKING STUDY
Objective: synthesis of new 1, 3-diphenyl pyrazole derivatives 9(a-f) and 10(a-f) using molecular hybridization approach for antitubercular and cytotoxic studies.Methods: The structures of synthesized compounds were conf...