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KMID : 0984720080400040207
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Infection and Chemotherapy
2008 Volume.40 No. 4 p.207 ~ p.211
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Time Kill Studies of Antibiotics against a Nalidixic Acid Resistant Salmonella enterica serotype Typhi
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Kim Dong-Min
Chung Jong-Hoon
Yoon Na-Ra
Ryu Hyun-Ho
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Abstract
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Background:We recently encountered a case of typhoid fever in a patient who visited us after travelling India. The patient received ciprofloxacin therapy, but developed typhoid pneumonia and typhoid hepatitis, and nalidixic acid resistance Salmonella Typhi (NARST) was identified. The aim of this study was to assess the in vitro efficacy of several antimicrobial combinations, which are commonly used in clinical practice.
Materials and Methods:Time-kill studies were performed for a clinical NARST strain to evaluate synergy. Synergy was defined as a ≥2 log10 decrease (100-fold drop) in CFU per mL at 24 hours by a drug combination compared to the most active constituent.
Results:The combination regimen of cefotaxime plus ciprofloxacin significantly reduced the bacterial counts (＞3 log CFU) at 3/4 MIC and at 24 hours compared to the ciprofloxacin or cefotaxime alone and showed synergistic effect against a NARST strain.
Conclusions:In conclusion, our time-kill studies showed that ciprofloxacin plus cefotaxime was the best in vitro combination against a NARST. This combination may improve efficacy compared to fluoroquinolone alone in typhoid fever patient with NARST. Time kill studies with more NARST strains and clinical studies are required to test the relevance of our findings.
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KEYWORD
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Typhoid fever, Salmonella Typhi, Cefotaxime, Ciprofloxacin
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