Dactimicin, a new aminoglycoside: in vitro activity, post-antibiotic effect and interaction with other antibiotics.

The in vitro activity of the new aminoglycoside dactimicin in comparison to amikacin was tested alone and in combination with piperacillin, mezlocillin and ceftazidime against freshly isolated clinical pathogens. Dactimicin was more active than amikacin against Enterobacter cloacae, Providencia rettgeri and Salmonella spp., and less active than amikacin against Escherichia coli, Pseudomonas aeruginosa and Acinetobacter anitratus. Using the checkerboard technique, the combination of either dactimicin or amikacin with the other drugs was shown to result in synergistic interaction against most of the 23 strains tested. Dactimicin-ceftazidime and amikacin-ceftazidime were the most effective combinations, demonstrating synergism against 91% and 95% of the isolates respectively. Antagonism was not encountered. Using the time-kill method, synergism was seen in most cases, indifference rarely being seen; antagonism was not observed. Dactimicin induced a post-antibiotic effect which ranged from 1 h for Enterobacter cloacae to 2.4 h for Escherichia coli. An average post-antibiotic effect of 0.6 h was also seen when dactimicin was combined with piperacillin, mezlocillin and ceftazidime. The findings indicate that dactimicin compares favorably in vitro with amikacin and suggest that clinical trials with this drug alone or in combination are warranted.