Cefotaxime in combination with other antibiotics for the treatment of severe methicillin-resistant staphylococcal infections

摘要: Methicillin-resistant staphylococci (M-R staphylococci) represent 30% of the staphylococcal strains isolated in our hospital and pose important therapeutic problems. In a preliminaryin vitro checker-board study bactericidal effect various cephalosporins (cephalothin, cefamandole, cefotaxime cefoperazone) combination with other antibiotics (netilmicin, amikacin, vancomycin fosfomycin) was studied on ten M-R strains. The combinations cefoperazone cephalothin four fosfomycin were synergistic (FBC indexes ⩽0.75). According to CSF bone levels achieved by these their concentrations combination, most interesting, concentration ⩽2 mg/l being five homogeneous M-RStaphylococcus aureus when combined 4 fosfomycin. This (25 mg/kg, i.v. infusion over 30 min) (50 three hours) times daily used treat 16 patients: patients meningitis, six joint infections seven persistent bacteremia. FBC ⩽0.625 for 12 studied. All cured without relapses. cefotaxime, desacetyl during meningitis hours after end second day treatment 8.76, 6.82 58.0 mg/l, respectively, patient one 2.0, 0.53 31.0 two. These good results allowed us eight methicillin-sensitive this combination. cured.