Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six antineoplastic antibiotics showed little antibacterial activity against 28 strains of four species of gram-negative enteric bacteria. By using the cellophane transfer technique, combinations of these agents with 16 antibacterial drugs usually showed indifference. However, combinations of mitomycin C, especially with the aminoglycosides, were synergistic on strains of Escherichia coli, Proteus, and Klebsiella pneumoniae. Bleomycin, on the other hand, often showed antagonism on strains of E. coli and K. pneumoniae with the beta-lactams, aminoglycosides, and other antibacterial agents. Checkerboard titrations and kinetic killing curves confirmed these findings.
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PMID:Bactericidal effect of combinations of antimicrobial drugs and antineoplastic antibiotics against gram-negative bacilli. 53 57

The combined effect of sisomicin and 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido-a1-penicillanic acid sodium salt (mezlocillin, Baypen) was studied against 50 bacterial strains, including Pseudomonas aeruginosa, Proteus spp. Klebsiella-Enterobacter, E. coli and Staphylococcus aureus. No antagonism or indifference was detected with the strains studied. Both antibiotics were synergistic against 62% of the strains, and partially synergistic against 38%. Out of the bacteria studied, Staphylococcus aureus was the most susceptible to the combined action of sisomicin and mezlocillin.
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PMID:Synergistic action between sisomicin and mezlocillin against gram-negative bacteria and Staphylococcus aureus. 54 94

Antimicrobial combinations are frequently needed for the successful treatment of serious infections. Generally, the same dosing schedules are employed irrespective of whether the drugs are used singly or in combination. A postantibiotic effect (PAE) has been described for all antibiotics used singly against Gram-positive cocci, but only for non-beta-lactams against Gram-negative bacilli with the exception of carbapenems against Pseudomonas aeruginosa. The major clinical relevance of the PAE pertains to its impact on antimicrobial dosing, where agents inducing a long PAE may be administered with longer dosing intervals than currently employed, without loss of efficacy. The purpose of this study was to examine whether PAEs induced by drug combinations differed from the PAEs induced by the drugs alone, and whether a pattern of synergism, addition or antagonism could be defined in this regard. The study organisms, 7 strains of Staphylococcus aureus, 4 strains of Escherichia coli, 4 strains of Klebsiella pneumoniae and 6 strains of Ps. aeruginosa, were exposed to several beta-lactams, aminoglycosides, rifampin and ciprofloxacin singly and in combination. The antimicrobial combinations used against S. aureus affected the PAE in either an additive or an indifferent manner when compared to the PAEs induced by the drugs as single agents. Enhancement of PAEs against Gram-negative bacilli was primarily dependent on the ability of each individual drug to induce a PAE. Thus, for a combination of drugs where both agents induced a PAE individually, the final PAE was a rough mathematical sum of the individual PAEs (addition). When only one of the agents induced a PAE, the final result was similar to the PAE of that particular drug (indifference). Ciprofloxacin seemed to be an exception to this rule, since it did not increase the PAE of a PAE producing drug, despite exhibiting a PAE itself. Rifampin was unique in that it prolonged the PAE in a marked synergistic fashion, when employed with one or more other PAE-producing agents. Further studies in vivo are clearly needed to confirm these observations, but they could have significant impact on the design of dosing regimens for antimicrobial combinations.
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PMID:The postantibiotic effect induced by antimicrobial combinations. 212 68

Synergy resulting from the combination of ciprofloxacin and an antipseudomonal penicillin has been reported for 20%-50% of isolates of Pseudomonas aeruginosa. A similar effect has also been reported for the combination of ciprofloxacin and fosfomycin. In contrast, the combination of quinolones and aminoglycosides rarely showed synergy when tested against P. aeruginosa. Most studies have shown that the combination of beta-lactams or aminoglycosides with quinolones is indifferent against Escherichia coli, Klebsiella species, Enterobacter species, Citrobacter species, and Serratia species. The combination of ciprofloxacin and chloramphenicol can be antagonistic against E. coli. In general, the combination of quinolone antibiotics with other drugs tested against staphylococci, enterococci, and anaerobic species has shown indifference. The neutropenic mouse model of infection has demonstrated the synergistic effect of ciprofloxacin plus antipseudomonal penicillins; the combination of ciprofloxacin and rifampin has been superior to single agents in experimental Staphylococcus aureus osteomyelitis. Ciprofloxacin has been the quinolone studied most thoroughly, and few data are available about the combination of other quinolones with other antimicrobial agents. Overall, the occurrence of synergy when quinolones are combined with other antimicrobial agents is infrequent, and clinical studies that demonstrate the clinical relevance of data from in vitro and animal models of infection are not available. However, data from in vitro and animal model studies indicate that the combination of a quinolone with other antimicrobial agents rarely results in antagonism.
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PMID:Synergy of fluoroquinolones with other antimicrobial agents. 250 55

FCE 22101 is a penem antibiotic with broad in-vitro activity similar to that of imipenem, although less active against Pseudomonas aeruginosa. Combinations of FCE 22101 with ciprofloxacin or gentamicin against methicillin-resistant Staphylococcus aureus and methicillin-resistant Staph. epidermidis resulted in addition or indifference by the chequerboard method. The combination of FCE 22101 and gentamicin against Streptococcus faecalis was usually additive. Against Enterobacter cloacae FCE 22101 had MICs of 16 mg/l whilst in combination with gentamicin (0.25-0.12 mg/l) the MICs were reduced to less than 2 mg/l. Ciprofloxacin and FCE 22101 showed only addition against Enterobacter spp. similar results were obtained with the combinations of FCE 22101 and gentamicin or ciprofloxacin tested against Citrobacter freundii. With Serratia spp. FCE 22101 and gentamicin showed synergy, but FCE 22101 and ciprofloxacin showed indifference. Similar results were obtained with strains of Escherichia coli and Klebsiella, Proteus, and Providencia spp. FCE 22101 plus gentamicin, or aztreonam, against Ps. aeruginosa usually showed indifference, but with ciprofloxacin addition was the rule. In general the combination of FCE 22101 with other agents resulted in an additive rather than a synergistic effect.
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PMID:In-vitro activity of FCE 22101 and synergy studies with other antimicrobial agents. 278 20

Combinations of ciprofloxacin with azlocillin, piperacillin and ticarcillin were tested in vitro against clinical isolates. Azlocillin plus ciprofloxacin showed synergy against 30% of Pseudomonas aeruginosa isolates; it was either synergistic or additive against 78% of all isolates tested even those resistant to the beta-lactam. Synergism was rarely noted for Klebsiella pneumoniae, Escherichia coli, Enterobacter spp. or Branhamella spp. isolates. Minimum inhibitory concentrations of ciprofloxacin plus azlocillin, plus piperacillin and plus ticarcillin against Pseudomonas spp. were reduced 4 or 2 fold, respectively. However, the combination azlocillin plus ciprofloxacin showed primarily indifference against gram-positive strains. Neutropenic mice infected with a lethal challenge of Pseudomonas spp. were protected by a combination of azlocillin and ciprofloxacin. Its additive and/or synergistic effects and expanded spectrum of activity against streptococci, methicillin-resistant staphylococci and JK corynebacteria may provide an alternative to traditional therapy.
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PMID:Synergy of ciprofloxacin and azlocillin in vitro and in a neutropenic mouse model of infection. 293 45

The in-vitro activity of ampicillin, of mecillinam and of combinations of ampicillin with mecillinam, clavulanic acid or 6 beta-bromopenicillanic acid has been studied against 126 Enterobacteriaceae resistant to ampicillin. The combination of ampicillin with mecillinam showed synergy or addition in 60% of the combinations tested. Synergy was seen especially when the strains were resistant to mecillinam, indifference when they were susceptible to mecillinam. The combination of ampicillin with mecillinam was more active than the combination with clavulanic acid against Escherichia coli, Klebsiella and Enterobacter, but not against Proteus, Morganella and Providencia. The combination of ampicillin with clavulanic acid was more active than the combination with 6 beta-bromopenicillanic acid in E. coli, Klebsiella and Enterobacter strains.
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PMID:In-vitro activity of the combinations of ampicillin with mecillinam or with beta-lactamase inhibitors against strains resistant to ampicillin. 387 48

Because of increased aminoglycoside resistance of hospital bacterial isolates, aminoglycoside sensitivity patterns of isolates in a large children's hospital were assessed before and during a 33-month period of almost exclusive amikacin use. There was no significant change in overall resistance rates of gram-negative enteric bacteria to gentamicin (4.8 percent and 4.6 percent), tobramycin (2.5 percent and 3.6 percent), and amikacin (1.2 percent and 1.8 percent) from the pre-amikacin period to the amikacin usage period, respectively. No significant differences were observed for isolates of Escherichia coli, Klebsiella, Serratia, Acinetobacter, and Pseudomonas species. In contrast, significant decreases in gentamicin and tobramycin resistance rates for Enterobacter, Citrobacter, and Pseudomonas aeruginosa and in gentamicin resistance of Proteus were found. Very little change in resistance of staphylococcal isolates was seen during a shorter evaluation period. Pediatric aminoglycoside usage includes therapy of neonatal infections, cystic fibrosis, febrile neutropenic episodes in patients with cancer, abdominal surgery, bacterial endocarditis, and gram-negative central nervous system infections. Amikacin has also been used successfully as single-dose therapy of urinary tract infections, and acceptable cerebrospinal fluid levels of amikacin have been documented in hydrocephalic patients with ventriculitis. In vitro studies of 22 bacterial isolates demonstrated synergy between amikacin and penicillin or newer cephalosporins in 13, an additive effect in seven and indifference in two. No antagonism was found. In addition, in vivo synergy between imipenem and amikacin was found in neutropenic infant rats with P. aeruginosa sepsis using a strain with which no synergy was demonstrable in vitro. Amikacin is effective in pediatric infections and is well tolerated by children. Because excessive or inadequate levels are frequent with usually recommended doses, particularly in neonates and patients with compromised renal function or cystic fibrosis, serum levels should be monitored to minimize risk and to ensure therapeutic levels.
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PMID:Treatment of pediatric infections with amikacin as first-line aminoglycoside. 402 67

The synergistic action of the combination netilmicin-piperacillin in comparison to gentamicin-piperacillin was studied in 206 clinical isolates of staphylococci, enterococci, Enterobacteriaceae and Pseudomonas aeruginosa by means of the checkerboard technique. Overall, netilmicin-piperacillin acted synergistically against 31% and gentamicin-piperacillin against 14% of the 206 strains. In particular, synergism was more frequently observed with netilmicin-piperacillin against Escherichia coli, Citrobacter spp., indole-positive Proteus spp. and Pseudomonas aeruginosa. Synergy was uncommon with either combination against enterococci, Staphylococcus epidermidis and Serratia spp. Only partial synergy or indifference was seen with both combinations against Klebsiella spp. The interaction of netilmicin would appear to be superior to that of gentamicin in combination with piperacillin.
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PMID:Comparative synergistic activity of netilmicin-piperacillin versus gentamicin-piperacillin. 621 66

The combination of clindamycin plus a new semisynthetic cephalosporin, U63196E for which the United States approved name is cefpimizole, was tested against 47 aerobic Gram-negative rods and 30 aerobic Gram-positive cocci. Synergy was seen with Klebsiella pneumoniae (3 of 19 isolates) and Escherichia coli (2 of 21 isolates). All isolates of Pseudomonas aeruginosa, Staphylococcus aureus, methicillin-resistant Staph. aureus, and enterococci demonstrated either indifference or antagonistic reactions to the drug combination.
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PMID:Interaction of clindamycin and cefpimizole (U63196E) in vitro against aerobic gram-negative rods and aerobic gram-positive cocci. 651 9


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