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Antimicrobial Agents and Chemotherapy, April 2000, p. 1035-1040, Vol. 44, No. 4
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

In Vitro Activities of Nontraditional Antimicrobials against Multiresistant Acinetobacter baumannii Strains Isolated in an Intensive Care Unit Outbreak

Maria D. Appleman,1,* Howard Belzberg,2 Diane M. Citron,1 Peter N. R. Heseltine,3 Albert E. Yellin,2 James Murray,2 and Thomas V. Berne2

Departments of Pathology,1 Surgery,2 and Medicine,3 Los Angeles County-University of Southern California Medical Center, Los Angeles, California

Received 11 January 1999/Returned for modification 29 April 1999/Accepted 13 December 1999

Fifteen multiresistant Acinetobacter baumannii isolates from patients in intensive care units and 14 nonoutbreak strains were tested to determine in vitro activities of nontraditional antimicrobials, including cefepime, meropenem, netilmicin, azithromycin, doxycycline, rifampin, sulbactam, and trovafloxacin. The latter five drugs were further tested against four of the strains for bactericidal or bacteriostatic activity by performing kill-curve studies at 0.5, 1, 2, and 4 times their MICs. In addition, novel combinations of drugs with sulbactam were examined for synergistic interactions by using a checkerboard configuration. MICs at which 90% of the isolates tested were inhibited for antimicrobials showing activity against the multiresistant A. baumannii strains were as follows (in parentheses): doxycycline (1 µg/ml), azithromycin (4 µg/ml), netilmicin (1 µg/ml), rifampin (8 µg/ml), polymyxin (0.8 U/ml), meropenem (4 µg/ml), trovafloxacin (4 µg/ml), and sulbactam (8 µg/ml). In the kill-curve studies, azithromycin and rifampin were rapidly bactericidal while sulbactam was more slowly bactericidal. Trovafloxacin and doxycycline were bacteriostatic. None of the antimicrobials tested were bactericidal against all strains tested. The synergy studies demonstrated that the combinations of sulbactam with azithromycin, rifampin, doxycycline, or trovafloxacin were generally additive or indifferent.

* Corresponding author. Mailing address: Los Angeles County-University of Southern California Medical Center, 1200 N. State St., Room 2014, Los Angeles, CA 90033. Phone: (323) 226-7016. Fax: (323) 226-4075. E-mail: mapplema{at}hsc.usc.edu.

Antimicrobial Agents and Chemotherapy, April 2000, p. 1035-1040, Vol. 44, No. 4
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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