[In vitro and in vivo activity of a combination of clavulanic acid and amoxicillin against Klebsiella pneumoniae producing extended broad-spectrum betalactamase (CTX-1, SHV-3, SHV-4)].

In vitro activity of an aminopenicillin (amoxicillin or ampicillin) combined with a betalactamase inhibitor (clavulanic acid or sulbactam, 2 mg/l) was examined against 39 strains of K. pneumoniae producing 3 types of extended broad spectrum betalactamases (CTX-1, SHV-3, SHV-4). Clavulanic acid produces the best synergistic effect. The in vivo activity of Augmentin (amoxicillin + clavulanic acid), 1 g once or twice a day, during 10 +/- 3 days was evaluated on 10 cases urinary tract infections in paraplegic patients. After 3 days, no leucocyturia was observed and bacteria were no more detected. The inhibitory effect of clavulanic acid for the extended broad-spectrum betalactamases shows that such an association could be probably chosen as well for treatment urinary infection.