E-test method for detecting antibiotic synergy against Pseudomonas aeruginosa from neutropenic patients: a cost-effective approach

New Microbiol. 2004 Jul;27(3):263-72.

Abstract

The aim of this study was to evaluate the accuracy of E-test for the detection of synergy or antagonism of antibiotic combinations against Pseudomonas aeruginosa isolates from neutropenic patients. The activity of levofloxacin or grepafloxacin combined with ceftriaxone or cefotaxime against 20 P. aeruginosa clinical strains was assessed by checkerboard technique in comparison with results performed by E-test. The combination grepafloxacin + ceftriaxone appeared to be most effective (synergy, 55%) by checkerboard technique. The agreement between checkerboard and E-test results was 71.2%. Synergy was detected by checkerboard and E-test methods in 35 (43.8%) and 23 (31.3%) of 80 possible combinations, respectively. Antagonism was detected once (1.2%) by checkerboard method only. No major errors were recorded. E-test was preferable to checkerboard method for the total cost (reagent cost + cost of technologist time) (8,60 vs 21,80 euros/test, respectively). E-test appeared a promising alternative for testing antibiotic combinations although further testing should be performed to better refine this metodology.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / complications
  • Anemia / microbiology
  • Anti-Bacterial Agents / pharmacology*
  • Cefotaxime / pharmacology
  • Ceftriaxone / pharmacology
  • Cost-Benefit Analysis
  • Drug Synergism*
  • Drug Therapy, Combination / pharmacology*
  • Fluoroquinolones / pharmacology
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / microbiology
  • Humans
  • Levofloxacin
  • Microbial Sensitivity Tests / economics
  • Microbial Sensitivity Tests / methods*
  • Neutropenia / microbiology*
  • Ofloxacin / pharmacology
  • Piperazines / pharmacology
  • Pseudomonas Infections / microbiology*
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / growth & development
  • Pseudomonas aeruginosa / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Piperazines
  • Levofloxacin
  • Ceftriaxone
  • Ofloxacin
  • grepafloxacin
  • Cefotaxime