Antimicrobial Agents and Chemotherapy, May 2000, p. 1153-1158, Vol. 44, No. 5
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

The Anti-Infective Research Laboratory, Department of Pharmacy Services, Detroit Receiving Hospital and University Health Center,1 College of Pharmacy and Allied Health Professions,2 and School of Medicine,3 Wayne State University, Detroit, Michigan 48201
Received 7 September 1999/Returned for modification 1 December 1999/Accepted 31 January 2000
The recent isolation of clinical strains of methicillin-resistant
Staphylococcus aureus (MRSA) with intermediate
susceptibility (MICs, 8 µg/ml) to vancomycin (vancomycin-intermediate
S. aureus [VISA]) emphasizes the importance of developing
novel antimicrobial regimens and/or agents for future treatment. We
studied the activities of ampicillin-sulbactam and trovafloxacin alone
or in combination against three unique strains of VISA in an in vitro
infection model. Two VISA strains were trovafloxacin susceptible (MICs,
2 µg/ml); one VISA strain was trovafloxacin resistant (MIC, 4 µg/ml). Trovafloxacin was administered to simulate a dose of 200 or
400 mg every 24 h. Ampicillin-sulbactam was administered to simulate a dose of 3 g every 6 h. Samples were removed from
the infection models over 48 h, and reductions in colony counts
were compared between regimens. Trovafloxacin (200 mg) produced rapid killing of a control MRSA strain over the 48-h experiment but produced
only slight killing of all three VISA strains. The higher dose of
trovafloxacin improved killing but did not produce bactericidal activity at 48 h. Ampicillin-sulbactam produced rapid bactericidal activity against all four strains tested, and colony counts at 8 h
were at the limits of detection. However, regrowth occurred by 48 h for each strain. The combination of ampicillin-sulbactam and
trovafloxacin provided additive activity against two of the three VISA
strains. In conclusion, trovafloxacin or ampicillin-sulbactam alone did
not provide adequate activity against the VISA strains for the 48-h
evaluation period, but the combination could help improve activity
against some strains of VISA.
Present address: School of Pharmacy, The University of Connecticut,
Storrs, CT 06269.
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