caa a22 4500 397592558 CHVBK 20180308164943.0 cr unu---uuuuu 161202e199604 xx s 000 0 eng 10.1093/jac/37.4.727 doi (NATIONALLICENCE)oxford-10.1093/jac/37.4.727 Unorthodox antibiotic combinations including ciprofloxacin against high-level gentamicin resistant enterococci [Elektronische Daten] [M. F. Tripodi, R. Utili, A. Rambaldi, A. Locatelli, P. Rosario, A. Florio, G. Ruggiero] Development of high-level gentamicin resistance among enterococci represents a serious therapeutic problem as it precludes synergy between aminoglycosides and cell-wall active agents. As part of a search for active antibiotic combinations against enterococci with high-level gentamicin resistance, we tested by the time kill curve method the efficacy of ciprofloxacin combined with ampicillin, trimethoprim-sulphamethoxazole, vancomycin or teicoplanin against ten isolates of Enterococcus faecium, three of Enterococcus casseliflavus and 13 of Enterococcus faecalis that exhibited a MIC of gentamicin ≥2000 mg/L. Most of the E. faecium were also resistant to ampicillin and to ciprofloxacin. The combination of ciprofloxacin with ampicillin was bactericidal against five of seven E. faecium strains that exhibited a ciprofloxacin MIC 4≤mg/L, but was inactive against the three E. faecium that were highly resistant to ciprofloxacin. This combination was also bactericidal against the E. casseliflavus and all the E. faecalis strains. The combination of ciprofloxacin with trimethoprim-sulphamethoxazole was bactericidal against five of the seven E. faecium and seven of the nine E. faecalis strains with a ciprofloxacin MIC ≤4mg/L. No bactericidal activity of this combination was seen against the enterococci that were highly resistant to either ciprofloxacin or to trimethoprim-sulphamethoxazole. The combination of ciprofloxacin with glycopeptides was inactive against E. faecium and E. casseliflavus and against E. faecalis, it was either ineffective or antagonistic; in only one case it was bactericidal. Five strains of E. faecium were resistant to all antibiotic combinations tested. © 1996 The British Society for Antimicrobial Chemotherapy Original articles nationallicence Tripodi M. F. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Utili R. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Rambaldi A. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Locatelli A. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Rosario P. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Florio A. Institute of Vascular Surgery, Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Ruggiero G. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut Journal of Antimicrobial Chemotherapy Oxford University Press 37/4(1996-04), 727-736 0305-7453 37:4<727 1996 37 jac https://doi.org/10.1093/jac/37.4.727 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/jac/37.4.727 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tripodi M. F. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Utili R. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Rambaldi A. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Locatelli A. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Rosario P. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Florio A. Institute of Vascular Surgery, Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 700 1- Ruggiero G. Institute of Medical Therapy; Second University of Naples Via D. Cotugno 1, 80135 Naples, Italy aut NATIONALLICENCE 773 0- Journal of Antimicrobial Chemotherapy Oxford University Press 37/4(1996-04), 727-736 0305-7453 37:4<727 1996 37 jac Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford