Gondane Ajitkumar A, Pawar Dattatray B
Medical Affairs, Alkem Laboratories, Mumbai, IND.
Cureus. 2023 Mar 13;15(3):e36078. doi: 10.7759/cureus.36078. eCollection 2023 Mar.
Background and objective Combining sulbactam with cefotaxime/ceftriaxone augments its antimicrobial activity against β-lactamase-producing bacteria. They are widely used as empirical treatment for many clinical infections. However, there is a scarcity of data on the susceptibility of various organisms to these antibiotics in the Indian region. In light of this, the present study evaluated the susceptibility of bacterial isolates to cefotaxime-sulbactam and compared it with ceftriaxone-sulbactam. Methodology Clinical samples with positive bacterial cultures from various laboratories in India were subjected to antibiotic sensitivity testing using E-test strips and disk diffusion methods to determine the minimum inhibitory concentration (MIC) and zone of inhibition (ZOI), respectively. MIC and MIC values were determined along with the measurement of the ZOI for the effectiveness of antibiotics. Interpretations of MIC and ZOI values were made as per the criteria set by the Clinical and Laboratory Standards Institute (CLSI) guidelines to estimate the proportion of sensitive organisms. Results Among 400 clinical isolates evaluated, (47.75%) was the most common organism isolated followed by (26%), (7.75%), (3.8%), and (2.8%). The mean ZOI was found significantly higher for and in the cefotaxime-sulbactam group than in the ceftriaxone-sulbactam group. MIC values for and were 0.25 and 0.19 µg/ml, respectively in the cefotaxime-sulbactam group as compared to 0.38 and 0.25 µg/ml, respectively for ceftriaxone-sulbactam. The proportion of sensitive isolates was also higher in the cefotaxime-sulbactam group for , and . Conclusions The effect of cefotaxime-sulbactam on organisms is similar to that of ceftriaxone-sulbactam in terms of MIC, ZOI, and proportion of sensitivity based on our study involving clinical isolates from various parts of India. Cefotaxime-sulbactam may be preferred in the empirical management of various clinical infections.
背景与目的 舒巴坦与头孢噻肟/头孢曲松联合使用可增强其对产β-内酰胺酶细菌的抗菌活性。它们被广泛用作多种临床感染的经验性治疗药物。然而,在印度地区,关于各种微生物对这些抗生素敏感性的数据却很匮乏。鉴于此,本研究评估了细菌分离株对头孢噻肟-舒巴坦的敏感性,并将其与头孢曲松-舒巴坦进行比较。方法 来自印度各实验室的细菌培养阳性的临床样本,分别采用E-test试纸条法和纸片扩散法进行抗生素敏感性测试,以确定最低抑菌浓度(MIC)和抑菌圈(ZOI)。同时测定MIC和MIC值以及ZOI,以评估抗生素的有效性。根据临床和实验室标准协会(CLSI)指南设定的标准对MIC和ZOI值进行解读,以估计敏感微生物的比例。结果 在评估的400株临床分离株中,(47.75%)是最常见的分离菌,其次是(26%)、(7.75%)、(3.8%)和(2.8%)。头孢噻肟-舒巴坦组中, 和 的平均抑菌圈明显高于头孢曲松-舒巴坦组。头孢噻肟-舒巴坦组中, 和 的MIC值分别为0.25和0.19μg/ml,而头孢曲松-舒巴坦组分别为0.38和0.25μg/ml。头孢噻肟-舒巴坦组中, 、 和 的敏感分离株比例也更高。结论 根据我们对来自印度各地临床分离株的研究,在MIC、ZOI和敏感比例方面,头孢噻肟-舒巴坦对微生物的作用与头孢曲松-舒巴坦相似。在各种临床感染的经验性治疗中,头孢噻肟-舒巴坦可能更受青睐。