Evaluation of combination chemotherapy in a lightly anesthetized animal model of Pseudomonas pneumonia.

Gram-negative bacillary pneumonia is a major cause of morbidity and mortality in hospitalized patients. The use of synergistic combinations of aminoglycosides and beta-lactams for therapy of this infection has been recommended but remains controversial. We designed a new model of Pseudomonas pneumonia in a lightly sedated guinea pig by using a long-acting anesthetic to impair natural respiratory defenses. We used this model to compare the efficacy of ceftazidime and tobramycin alone and in combination in the therapy of Pseudomonas pneumonia. The two antibiotics were shown to be synergistic in vitro for the strain of Pseudomonas aeruginosa tested. Treated animals receiving both antibiotics had fewer viable bacteria remaining in lung tissues (P less than 0.05) and exhibited a trend towards improved survival in comparison to animals receiving a single drug. In this model of Pseudomonas pneumonia, in vitro synergy was reflected by increased efficacy in vivo.