Christine Warren

Decreased susceptibility of Neisseria gonorrhoeae to ciprofloxacin

We report a patient with uncomplicated gonorrhoea who did not respond to ciprofloxacin and whose isolates had reduced sensitivity to this drug and other quinolones

In vitro antibacterial activity of norfloxacin (MK-0366).

The in vitro activity of norfloxacin (MK-0366) compared with that of beta-lactam antibiotics and, where appropriate of gentamicin or metronidazole was assessed against recent clinical isolates of common bacteria. The compound was highly active against most enterobacteria (minimal inhibitory concentrations [MICs], 0.008 to 32 micrograms/ml; 90% inhibited by 0.25 micrograms/ml), Haemophilus influenzae (MICs, 0.03 to 0.12 micrograms/ml), and Neisseria gonorrhoeae (MICs, 0.008 to 0.016 micrograms/ml). It was also active against Pseudomonas aeruginosa (MICs, 0.12 to 2 micrograms/ml), most other pseudomonads (MICs, 0.03 to 32 micrograms/ml), and Acinetobacter calcoaceticus (MICs 0.06 to 4 micrograms/ml). Norfloxacin was somewhat less active against staphylococci (MICs, 0.25 to 4 micrograms/ml; 1 microgram/ml required to inhibit 50% of isolates) and streptococci (MICs, 0.5 to 64 micrograms/ml). Members of the Bacteroides fragilis group of anaerobes were relatively resistant to norfloxacin (MICs, 8 to 128 micrograms/ml), as were most other anaerobes.

In vitro antibacterial activity and susceptibility of the cephalosporin Ro 13-9904 to beta-lactamases.

The in vitro activity of Ro 13-9904 was assessed against clinical isolated of common bacteria. Its activity against most enterobacteria was similar to that of cefotaxime and moxalactam, but it was even more active than these compounds against all Proteus species. It was also highly active against Haemophilus influenzae and Neisseria gonorrhoeae, including beta-lactamase producers. Like cefotaxime and moxalactam, Or 13-9904 was approximately eightfold more active than carbenicillin against most isolates of Pseudomonas aeruginosa and also active against highly carbenicillin-resistant isolates, but it was relatively inactive against moderately carbenicillin-resistant isolates. Ro 13-9904 also resembled cefotaxime and moxalactam in that it was active, though less so than cephaloridine, against staphylococci and streptococci, except for methicillin-resistant staphylococci and Streptococcus faecalis, which were resistant to it. It was less active than cefoxitin but slightly more active than ampicillin against both Bacteroides fragilis and other Bacteroides spp. Ro 13-9904 was resistant to most beta-lactamases but was attacked by enzymes from B. fragilis, isolates of indole-positive Proteus species, and also by a cefoxitin-hydrolyzing enzyme from an isolate of Enterobacter cloacae.

Activity of Sulfamethoxazole and Trimethoprim Against Bacteroides fragilis

Minimum inhibitory concentrations (MICs) of sulfamethoxazole (SMX) and trimethoprim (TMP), alone and in three combinations, 20:1, 1:1, and 1:20, were determined on Diagnostic Sensitivity Test (DST) and Mueller-Hinton (MH) agars containing lysed blood for various inocula of 91 strains of Bacteroides fragilis from the U.S.A. and U.K. MICs of SMX were high with large inocula and higher on MH than DST, but results for TMP were less affected by these two factors. True SMX resistance was rare: 10 U.S.A. strains previously reported as resistant appeared to be susceptible. Maximum potentiation of MICs was observed when SMX and TMP were combined in ratios close to those of the ratios of their MICs, that is, SMX/TMP 20:1 for large inocula and the reverse for small inocula for determinations on DST and usually 20:1 for all inoculum sizes on MH. These observations explain some of the discrepancies in reports, but defer the problem of potential usefulness of the drugs in the treatment of infection with anaerobes to future study.

In-vitro antigonococcal activity of rosoxacin (WIN 35213).

The in-vitro activity of rosoxacin against 173 isolates of Neisseria gonorrhoeae, including 17 beta-lactamase-producers, was tested by an agar dilution method. Of the isolates, 167 (including 16 of the beta-lactamase-producers) were inhibited by 0 . 06 mg/l of rosoxacin. The remaining six isolates, one of which produced beta-lactamase and the others were moderately resistant to penicillin, were inhibited by 0 . 12-0 25 mg/l of the compound. There was little correlation between the minimum inhibitory concentrations (MICs) of rosoxacin and penicillin, except for isolates with MICs of penicillin of 0 . 06-1 mg/l, for which correlation was good.