This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Climo, M. W.
Right arrow Articles by Archer, G. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Climo, M. W.
Right arrow Articles by Archer, G. L.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, July 1999, p. 1747-1753, Vol. 43, No. 7
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Combinations of Vancomycin and beta -Lactams Are Synergistic against Staphylococci with Reduced Susceptibilities to Vancomycin

Michael W. Climo,1,2,* Roberto L. Patron,1 and Gordon L. Archer1,3

Departments of Medicine1 and Microbiology/Immunology,3 Medical College of Virginia Campus of Virginia Commonwealth University, and the Hunter Holmes McGuire Veterans Affairs Medical Center,2 Richmond, Virginia

Received 7 December 1998/Returned for modification 26 February 1999/Accepted 6 April 1999

Evidence of synergism between combinations of vancomycin and beta -lactam antibiotics against 59 isolates of methicillin-resistant staphylococci (Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus haemolyticus) for which vancomycin MICs ranged from 1 to 16 µg/ml were tested by broth microdilution checkerboard, disk diffusion, agar dilution, and time-kill antimicrobial susceptibility tests. The combination of vancomycin and oxacillin demonstrated synergy by all test methods against 30 of 59 isolates; no antagonism was seen. Synergy with vancomycin was also found by modified disk diffusion testing for ceftriaxone, ceftazidime, cefpodoxime, and amoxicillin-clavulanate but not for aztreonam. Evidence of synergy correlated directly with vancomycin MICs. The efficacy of vancomycin given alone and in combination with nafcillin was tested in the rabbit model of experimental endocarditis caused by three clinical isolates of glycopeptide-intermediate-susceptible S. aureus (GISA) (isolates HIP5827, HIP5836, and MU50). Two of the GISA isolates (isolates MU50 and HIP5836) were extremely virulent in this model, with 27 of 42 (64%) animals dying during the 3-day trial. Therapy with either vancomycin or nafcillin given as a single agent was ineffective for animals infected with HIP5827 or MU50. However, the combination of vancomycin and nafcillin resulted in a mean reduction of 4.52 log10 CFU/g of aortic valvular vegetations per g compared to the reduction for controls for animals infected with HIP5827 and a reduction of 4.15 log10 CFU/g for animals infected with MU50. Renal abscesses caused by HIP5827 were sterilized significantly better with the combination of vancomycin and nafcillin than by either treatment alone. We conclude that the combination of vancomycin and beta -lactams with antistaphylococcal activity is an effective regimen for the treatment of infections with clinical strains of staphylococci which demonstrate reduced susceptibility to glycopeptides.

* Corresponding author. Mailing address: McGuire Veterans Affairs Medical Center, 1201 Broad Rock Blvd., Section 111-C, Richmond, VA. Phone: (804) 675-5018. Fax: (804) 675-5437. E-mail: Climo.Michael{at}Richmond.va.gov or MWCLIMO{at}aol.com.

Antimicrobial Agents and Chemotherapy, July 1999, p. 1747-1753, Vol. 43, No. 7
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


This article has been cited by other articles:

  • Noto, M. J., Fox, P. M., Archer, G. L. (2008). Spontaneous Deletion of the Methicillin Resistance Determinant, mecA, Partially Compensates for the Fitness Cost Associated with High-Level Vancomycin Resistance in Staphylococcus aureus. Antimicrob. Agents Chemother. 52: 1221-1229 [Abstract] [Full Text]  
  • Fox, P. M., Lampen, R. J., Stumpf, K. S., Archer, G. L., Climo, M. W. (2006). Successful Therapy of Experimental Endocarditis Caused by Vancomycin-Resistant Staphylococcus aureus with a Combination of Vancomycin and {beta}-Lactam Antibiotics.. Antimicrob. Agents Chemother. 50: 2951-2956 [Abstract] [Full Text]  
  • Vignaroli, C., Biavasco, F., Varaldo, P. E. (2006). Interactions between Glycopeptides and {beta}-Lactams against Isogenic Pairs of Teicoplanin-Susceptible and -Resistant Strains of Staphylococcus haemolyticus.. Antimicrob. Agents Chemother. 50: 2577-2582 [Abstract] [Full Text]  
  • Domenech, A., Ribes, S., Cabellos, C., Taberner, F., Tubau, F., Dominguez, M. A., Montero, A., Linares, J., Ariza, J., Gudiol, F. (2005). Experimental study on the efficacy of combinations of glycopeptides and {beta}-lactams against Staphylococcus aureus with reduced susceptibility to glycopeptides. J Antimicrob Chemother 56: 709-716 [Abstract] [Full Text]  
  • Madrigal, A. G., Basuino, L., Chambers, H. F. (2005). Efficacy of Telavancin in a Rabbit Model of Aortic Valve Endocarditis Due to Methicillin-Resistant Staphylococcus aureus or Vancomycin-Intermediate Staphylococcus aureus. Antimicrob. Agents Chemother. 49: 3163-3165 [Abstract] [Full Text]  
  • Sakoulas, G., Eliopoulos, G. M., Fowler, V. G. Jr., Moellering, R. C. Jr., Novick, R. P., Lucindo, N., Yeaman, M. R., Bayer, A. S. (2005). Reduced Susceptibility of Staphylococcus aureus to Vancomycin and Platelet Microbicidal Protein Correlates with Defective Autolysis and Loss of Accessory Gene Regulator (agr) Function. Antimicrob. Agents Chemother. 49: 2687-2692 [Abstract] [Full Text]  
  • Chambers, H. F. (2005). Evaluation of Ceftobiprole in a Rabbit Model of Aortic Valve Endocarditis Due to Methicillin-Resistant and Vancomycin-Intermediate Staphylococcus aureus. Antimicrob. Agents Chemother. 49: 884-888 [Abstract] [Full Text]  
  • Task Force Members, , Horstkotte, D., Follath, F., Gutschik, E., Lengyel, M., Oto, A., Pavie, A., Soler-Soler, J., Thiene, G., von Graevenitz, A., ESC Committee for Practice Guidelines, , Priori, S. G., Alonso Garcia, M. A., Blanc, J.-J., Budaj, A., Cowie, M., Dean, V., Deckers, J., Fernandez Burgos, E., Lekakis, J., Lindahl, B., Mazzotta, G., Morais, J., Oto, A., Smiseth, O. A., Document Reviewers, , Lekakis, J., Vahanian, A., Delahaye, F., Parkhomenko, A., Filipatos, G., Aldershvile, J., Vardas, P. (2004). Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Executive Summary: The Task Force on Infective Endocarditis of the European Society of Cardiology. Eur Heart J 25: 267-276 [Full Text]  
  • Cabellos, C., Fernandez, A., Maiques, J. M., Tubau, F., Ardanuy, C., Viladrich, P. F., Linares, J., Gudiol, F. (2003). Experimental Study of LY333328 (Oritavancin), Alone and in Combination, in Therapy of Cephalosporin-Resistant Pneumococcal Meningitis. Antimicrob. Agents Chemother. 47: 1907-1911 [Abstract] [Full Text]  
  • Pavie, J., Lefort, A., Ploy, M.-C., Massias, L., Chau, F., Garry, L., Denis, F., Fantin, B. (2003). Influence of Reduced Susceptibility to Glycopeptides on Activities of Vancomycin and Teicoplanin against Staphylococcus aureus in Experimental Endocarditis. Antimicrob. Agents Chemother. 47: 2018-2021 [Abstract] [Full Text]  
  • Jacqueline, C., Caillon, J., Le Mabecque, V., Miegeville, A.-F., Donnio, P.-Y., Bugnon, D., Potel, G. (2003). In vitro activity of linezolid alone and in combination with gentamicin, vancomycin or rifampicin against methicillin-resistant Staphylococcus aureus by time-kill curve methods. J Antimicrob Chemother 51: 857-864 [Abstract] [Full Text]  
  • Oliva, B., Miller, K., Caggiano, N., O'Neill, A. J., Cuny, G. D., Hoemann, M. Z., Hauske, J. R., Chopra, I. (2003). Biological Properties of Novel Antistaphylococcal Quinoline-Indole Agents. Antimicrob. Agents Chemother. 47: 458-466 [Abstract] [Full Text]  
  • O'Neill, A. J., Bostock, J. M., Morais Moita, A., Chopra, I. (2002). Antimicrobial activity and mechanisms of resistance to cephalosporin P1, an antibiotic related to fusidic acid. J Antimicrob Chemother 50: 839-848 [Abstract] [Full Text]  
  • Petersen, P. J., Bradford, P. A., Weiss, W. J., Murphy, T. M., Sum, P. E., Projan, S. J. (2002). In Vitro and In Vivo Activities of Tigecycline (GAR-936), Daptomycin, and Comparative Antimicrobial Agents against Glycopeptide-Intermediate Staphylococcus aureus and Other Resistant Gram-Positive Pathogens. Antimicrob. Agents Chemother. 46: 2595-2601 [Abstract] [Full Text]  
  • Srinivasan, A., Dick, J. D., Perl, T. M. (2002). Vancomycin Resistance in Staphylococci. Clin. Microbiol. Rev. 15: 430-438 [Abstract] [Full Text]  
  • Batard, E., Jacqueline, C., Boutoille, D., Hamel, A., Drugeon, H. B., Asseray, N., Leclercq, R., Caillon, J., Potel, G., Bugnon, D. (2002). Combination of Quinupristin-Dalfopristin and Gentamicin against Methicillin-Resistant Staphylococcus aureus: Experimental Rabbit Endocarditis Study. Antimicrob. Agents Chemother. 46: 2174-2178 [Abstract] [Full Text]  
  • Kiri, N., Archer, G., Climo, M. W. (2002). Combinations of Lysostaphin with {beta}-Lactams Are Synergistic against Oxacillin-Resistant Staphylococcus epidermidis. Antimicrob. Agents Chemother. 46: 2017-2020 [Abstract] [Full Text]  
  • Benquan, W., Yingchun, T., Kouxing, Z., Tiantuo, Z., Jiaxing, Z., Shuqing, T. (2002). Staphylococcus Heterogeneously Resistant to Vancomycin in China and Antimicrobial Activities of Imipenem and Vancomycin in Combination against It. J. Clin. Microbiol. 40: 1109-1112 [Abstract] [Full Text]  
  • Elsaghier, A. A. F., Aucken, H. M., Hamilton-Miller, J. M., Shaw, S., Kibbler, C. C. (2002). Resistance to teicoplanin developing during treatment of methicillin-resistant Staphylococcus aureus infection. J Antimicrob Chemother 49: 423-424 [Full Text]  
  • Climo, M. W., Ehlert, K., Archer, G. L. (2001). Mechanism and Suppression of Lysostaphin Resistance in Oxacillin-Resistant Staphylococcus aureus. Antimicrob. Agents Chemother. 45: 1431-1437 [Abstract] [Full Text]  
  • Aritaka, N., Hanaki, H., Cui, L., Hiramatsu, K. (2001). Combination Effect of Vancomycin and {beta}-Lactams against a Staphylococcus aureus Strain, Mu3, with Heterogeneous Resistance to Vancomycin. Antimicrob. Agents Chemother. 45: 1292-1294 [Abstract] [Full Text]  
  • Aeschlimann, J. R., Allen, G. P., Hershberger, E., Rybak, M. J. (2000). Activities of LY333328 and Vancomycin Administered Alone or in Combination with Gentamicin against Three Strains of Vancomycin-Intermediate Staphylococcus aureus in an In Vitro Pharmacodynamic Infection Model. Antimicrob. Agents Chemother. 44: 2991-2998 [Abstract] [Full Text]  
  • Biavasco, F., Vignaroli, C., Lazzarini, R., Varaldo, P. E. (2000). Glycopeptide Susceptibility Profiles of Staphylococcus haemolyticus Bloodstream Isolates. Antimicrob. Agents Chemother. 44: 3122-3126 [Abstract] [Full Text]  
  • Haraga, I., Nomura, S., Nagayama, A. (1999). The Effects of Vancomycin and {beta}-Lactam Antibiotics on Vancomycin-Resistant Staphylococcus aureus. NEJM 341: 1624-1624 [Full Text]  
  • (1999). Vancomycin Plus Beta-Lactams Equals Synergy Against GISA. JWatch Infect. Diseases 1999: 13-13 [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»