[Comparative study of the bactericidal activity of cefepime and cefpirome in association with glycopeptides against Staphylococci sensitive and resistant to methicillin].

The aim of this study was to evaluate by a kinetic time-kill method the synergy and bactericidal activity of cefepime and cefpirome in association with vancomycin and teicoplanin against 4 coagulase-positive and 7-negative staphylococci strains. Among these 2 were susceptible to methicillin and 7 resistant. Antibiotic concentrations used for time-kill curves were 0.5 and 1 CMI for glycopeptides and 32 mg/l for cephalosporins. Bactericidal activity was defined as a 3 log10 reduction of the initial inoculum. Cephalosporins at 32 mg/l and teicoplanin at 1 CMI were not bactericidal, while vancomycin at 1 CMI was bactericidal in 24 to 48 h for 3 strains. Cefepime and cefpirome in association with vancomycin were bactericidal against all strains with no secondary regrowth. Bactericidal activity was observed for 6 and 9 strains with the combinations of cefepime-teicoplanin and cefpirome-teicoplanin respectively. In conclusion, despite no significant antistaphylococcal activity of cefepime and cefpirome, their association to glycopeptides improved the bactericidal activity of vancomycin and teicoplanin.