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Cefoperazone/sulbactam: New composites against multiresistant gram negative bacteria?
- Source :
- Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 88
- Publication Year :
- 2020
-
Abstract
- Sulbactam, a class A β-lactamase inhibitor, added to cefoperazone either at a fixed 8 mg/L level of sulbactam or at a level of fixed cefoperazone: sulbactam ratio (2:1) would constitute a combination form of cefoperazone/sulbactam, which has better activities against Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii than cefoperazone alone. Cefoperazone/sulbactam (1:1 or 1:2) has greater in-vitro activity against most multidrug-resistant organisms (ESBL- and AmpC-producing Enterobacteriaceae and carbapenem-resistant A. baumannii except for carbapenem-resistant P. aeruginosa) than a 2:1 ratio. However, increased sulbactam concentration may induce AmpC production. Besides, sulbactam concentration might not be readily achievable in serum if the susceptibility rates were defined by the breakpoints of higher sulbactam composites, such as ≤16/16 (1:1) or 16/32 (1:2) mg/L. Carbapenemases (KPC-, OXA-type enzymes and metallo-β-lactamases) can't be inhibited by sulbactam. Some in-vitro studies showed that increasing sulbactam composites of cefoperazone/sulbactam had no effect on carbapenem-resistant P. aeruginosa, suggesting the presence of carbapenemases or AmpC overproduction that could not be overcome by increasing sulbactam levels to recover cefoperazone activity. Sulbactam alone has good intrinsic activity against carbapenem-resistant Acinetobacter strains sometimes even in the presence of carbapenemase genes, suggesting unsteady levels of carbapenemases. In conclusion, appropriate composites of cefoperazone and β-lactamase inhibitor sulbactam may expand the clinical use if the pharmacokinetic optimization could be achieved in the human serum.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Gram-negative bacteria
030106 microbiology
Cefoperazone
Microbial Sensitivity Tests
medicine.disease_cause
Microbiology
beta-Lactamases
03 medical and health sciences
Bacterial Proteins
Drug Resistance, Multiple, Bacterial
Gram-Negative Bacteria
polycyclic compounds
Genetics
medicine
Humans
Composite material
Molecular Biology
Ecology, Evolution, Behavior and Systematics
biology
Pseudomonas aeruginosa
organic chemicals
Sulbactam
biochemical phenomena, metabolism, and nutrition
Acinetobacter
bacterial infections and mycoses
biology.organism_classification
Enterobacteriaceae
Acinetobacter baumannii
Anti-Bacterial Agents
Drug Combinations
030104 developmental biology
Infectious Diseases
bacteria
Cefoperazone+Sulbactam
medicine.drug
Subjects
Details
- ISSN :
- 15677257
- Volume :
- 88
- Database :
- OpenAIRE
- Journal :
- Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases
- Accession number :
- edsair.doi.dedup.....872ffc951f5ce7a48131e1da6dc9c551