In vitro activity of azithromycin (CP-62,993), a novel macrolide, against enteric pathogens.

Azithromycin (CP-62,993 [9-deoxy-9A-methyl-9A-aza-9A-homoerythromycin]) is a novel macrolide antimicrobial. In this study the in vitro activity of CP-62,993 has been determined against selected enteropathogens, including Clostridium difficile, and compared with that of erythromycin. MICs were determined using an agar incorporation technique in Mueller-Hinton medium, containing saponin-lysed horse blood at a final concentration of 10% v/v, with an inoculum of 10(4) cfu. CP-62,993 was considerably more active than erythromycin against Salmonella typhi (MIC90 4 and greater than 32 mg/l, respectively), S. enteritidis (MIC90 4 and greater than 32 mg/l), Shigella flexneri (MIC90 2 and 32 mg/l), Sh. dysenteriae (MIC90 2 and 32 mg/l), Sh. sonnei (MIC90 4 and 32 mg/l), Campylobacter jejuni (MIC90 0.12 and 1 mg/l), Vibrio cholerae (MIC90 0.25 and 8 mg/l), V. parahaemolyticus (MIC90 0.5 and 8 mg/l), Yersinia enterocolitica (MIC90 4 and greater than 32 mg/l), Escherichia coli-ETEC (MIC90 4 and 32 mg/l), E. coli-EIEC (MIC90 4 and greater than 32 mg/l), Plesiomonas shigelloides (MIC90 1 and 8 mg/l) and Aeromonas hydrophila (MIC90 4 and 32 mg/l). CP-62,993 (MIC90 2 mg/l) was slightly less active than erythromycin (MIC90 1 mg/l) against isolates of C. difficile. The results suggest a potential clinical role for CP-62,993 in the treatment of enteric infections where antimicrobial therapy is indicated.