Comparative Activity of Piperacillin/Tazobactam against Clinical Isolates of Extended- Spectrum β-Lactamase-Producing Enterobacteriaceae

Publisher: Karger

E-ISSN: 1421-9794|44|6|377-384

ISSN: 0009-3157

Source: Chemotherapy, Vol.44, Iss.6, 1998-10, pp. : 377-384

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Abstract

β-Lactam resistance on the part of the Enterobacteriaceae causes serious therapeutic problems in our institutions due to their production of extended-spectrum β-lactamases (ESβLs). We studied the in vitro activity of β-lactam/β-lactamase inhibitor combinations and third-generation cephalosporins and monobactams against 71 clinically relevant Enterobacteriaceae which produced TEM- and SHV-derivative ESβLs. Of the single drugs and combinations tested, piperacillin/tazobactam proved to be the most effective. Piperacillin/tazobactam was highly active against Proteus mirabilis, with minimum inhibitory concentrations (MICs) ranging from 0.125 to 16 µg/ml; Escherichia coli (MICs from 2 to 16 µg/ml) and Serratia marcescens (MICs from 4 to 8 µg/ml), while its activity against Klebsiella pneumoniae ESβL producers turned out to be closely related to the type and the amount of enzyme produced, the MIC ranging from 1 to 128 µg/ml. The antibacterial activity of piperacillin/tazobactam was stronger than that of ticarcillin/clavulanate, ceftriaxone, cefotaxime, ceftazidime and aztreonam, and the combination shared favorable in vitro activity properties against the ESβL producers with imipenem which, however, should be kept as reserve product.

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