Postantibiotic effect of roxithromycin, erythromycin, and clindamycin against selected gram-positive bacteria and Haemophilus influenzae.

Recent experimental work has shown that a so-called PAE (postantibiotic effect, i.e. persistent suppression of regrowth after short exposure of bacteria to the study drug in vitro) is a feature of most current antibiotics. However, marked quantitative differences were found between different types of antibiotics and also between Gram-positive and Gram-negative organisms studied. A PAE has not yet been demonstrated for roxithromycin, a new macrolide antibiotic. Therefore, we compared the PAE of roxithromycin, erythromycin, and clindamycin against laboratory strains and clinical isolates of Staphylococcus aureus, Streptococcus pyogenes, Str. pneumoniae, and Haemophilus influenzae in vitro. Identical multiples of the MIC and identical exposure times resulted in similar PAEs for the three study drugs tested. Good correlations could be found between the area under the in-vitro concentration-vs-time curve (AUC) and PAEs. The longest PAE of 9.6 h was observed after exposure of Str. pneumoniae to 1.9 mg/l of roxithromycin for 6 h.