Examining the Combination of Cefixime and Amoxicillin/Clavulanate against Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolates

Antimicrobial Section / Original Paper

Thelen H.a· Dilworth T.J.b· Mercier R.-C.a

Author affiliations

aDepartment of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
bDepartment of Pharmacy, Advocate Aurora Health Milwaukee, Milwaukee, WI, USA

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Article / Publication Details

First-Page Preview

Abstract of Antimicrobial Section / Original Paper

Received: February 08, 2022
Accepted: April 05, 2022
Published online: May 02, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 2

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

Abstract

Introduction: Community-acquired urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli have limited oral therapeutic options and pose significant clinical challenges. The goal of this study was to evaluate the in vitro synergy between CFM and AMC against ESBL E. coli with aims to identify an oral treatment option for UTIs. Methods: Minimum inhibitory concentrations (MICs) of CFM in the presence of AMC were determined for 46 clinical isolates by placing a CFM Etest on a plate with AMC impregnated in the agar. Isolates with CFM MIC ≤1 μg/mL in the presence of AMC were considered susceptible to the CFM and AMC combination. Five isolates were then selected for further testing using time-kill analysis in the presence of CFM, AMC, and CFM with AMC. Time-kill curves were plotted to determine synergy over 24 h. Results: AMC improved the activity of CFM against ESBL E. coli isolates by 128-fold in the Etest analysis with 85% of tested isolates being susceptible to the combination. A fourfold or greater reduction in CFM MIC was exhibited in 44 of 46 (96%) isolates when in the presence of AMC. Synergy and bactericidal activity between CFM and AMC were exhibited in each of the five isolates tested by time-kill analysis. Discussion/Conclusion: This study found that AMC improves the activity of CFM against ESBL E. coli and that this antibiotic combination has potential as an oral therapeutic option to treat ESBL E. coli UTIs.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Antimicrobial Section / Original Paper

Received: February 08, 2022
Accepted: April 05, 2022
Published online: May 02, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 2

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

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