Comparative activity of piperacillin/tazobactam against clinical isolates of extended-spectrum β-lactamase-producing enterobacteriaceae

Laura Pagani, Roberta Migliavacca, Francesco Luzzaro, Ernesto Giacobone, Mariagrazia Perilli, Piero Micheletti, Gianfranco Amicosante

Research output: Contribution to journalArticlepeer-review

Abstract

β-Lactam resistance on the part of the Enterobacteriaceae causes serious therapeutic problems in our institutions due to their production of extended-spectrum β-lactamases (ESβLs). We studied the in vitro activity of β-lactam/β-lactamase inhibitor combinations and third-generation cephalosporins and monobactams against 71 clinically relevant Enterobacteriaceae which produced TEM- and SHV-derivative ESβLs. Of the single drugs and combinations tested, piperacillin/tazobactam proved to be the most effective. Piperacillin/tazobactam was highly active against Proteus mirabilis, with minimum inhibitory concentrations (MICs) ranging from 0.125 to 16 μg/ml; Escherichia coli (MICs from 2 to 16 μg/ml) and Serratia marcescens (MICs from 4 to 8 μg/ml), while its activity against Klebsiella pneumoniae ESβL producers turned out to be closely related to the type and the amount of enzyme produced, the MIC ranging from 1 to 128 μg/ml. The antibacterial activity of piperacillin/tazobactam was stronger than that of ticarcillin/clavulanate, ceftriaxone, cefotaxime, ceftazidime and aztreonam, and the combination shared favorable in vitro activity properties against the ESβL producers with imipenem which, however, should be kept as reserve product.

Original languageEnglish
Pages (from-to)377-384
Number of pages8
JournalChemotherapy
Volume44
Issue number6
DOIs
Publication statusPublished - Nov 1998

Keywords

  • β-Lactam/β-lactamase inhibitors
  • Aztreonam
  • Cefotaxime
  • Ceftazidime
  • Ceftriaxone
  • Enterobacteriaceae
  • Extended-spectrum β-lactamase
  • Piperacillin/tazobactam

ASJC Scopus subject areas

  • Pharmacology (medical)

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