| Literature DB >> 28167549 |
Zackery P Bulman1,2, Michael J Satlin3, Liang Chen4, Barry N Kreiswirth4, Beom Soo Shin5, Thomas J Walsh3, Patricia N Holden1,2, Alan Forrest6, Roger L Nation7, Jian Li7, Brian T Tsuji8,2.
Abstract
Pharmacodynamics of a polymyxin B, meropenem, and rifampin triple combination were examined against Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) ST258. In time-kill experiments against three KPC-Kp isolates, triple combination generated 8.14, 8.19, and 8.29 log10 CFU/ml reductions within 24 h. In the hollow-fiber infection model, the triple combination caused maximal killing of 5.16 log10 CFU/ml at 78 h and the time required for regrowth was more than doubled versus the 2-drug combinations. Remarkably, combinations with a high single-dose polymyxin B burst plus rifampin preserved KPC-Kp polymyxin susceptibility (MIC240 h = 0.5 mg/liter) versus the same combination with traditionally dosed polymyxin B, where resistance was amplified (MIC240 h = 32 mg/liter).Entities:
Keywords: KPC-producing K. pneumoniae; PK/PD; meropenem; polymyxin B; rifampin
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Year: 2017 PMID: 28167549 PMCID: PMC5365650 DOI: 10.1128/AAC.02023-16
Source DB: PubMed Journal: Antimicrob Agents Chemother ISSN: 0066-4804 Impact factor: 5.191