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IN-VITRO EFFICACY EVALUATION OF ANTIMICROBIAL COMBINATION ON PNEUMOCOCCAL-INFECTED- COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN
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Abstract
Introduction: Antibiotics and combination regimens are of importance in the treatment of Community-Acquired Pneumonia (CAP). In the face of the rapid emergence of multidrug-resistant pneumococcal strains, it is necessary to re-evaluate the efficacy of combination therapies to support controlling antimicrobial resistance and selecting appropriate regimens for the treatment of CAP. Objectives: To investigate the synergistic effect of some commonly used combination therapy for the treatment of CAP on multidrug-resistant pneumococcal isolates. Methods: The experimental study was conducted to evaluate the synergistic effects of several dual antimicrobial therapies on multidrug-resistant pneumococcal isolates using E-test methods. Results: The presence of azithromycin, gentamicin reduced the MIC of antibiotics used in combination with cefotaxime, ceftriaxone on the pneumococcal strains. Gentamicin-plus-cefotaxime and gentamicin-plus-ceftriaxone combinations showed the additive antimicrobial effects on the pneumococcal strain Pca; however, there were no clear synergistic activities. Macrolide and beta-lactam combinations have not shown in vitro synergistic bactericidal effects. Conclusions: In the case of CAP induced by multidrug-resistant Streptococcus pneumoniae, combining macrolides and β-lactams does not produce in vitro synergistic effects. The clinicians should carefully consider the selection of appropriate antibiotic combinations to enhance the treatment efficacy.
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Keywords
Combination therapy, in vitro, E-test, Community-Acquired Pneumonia, Streptococcus pneumoniae
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