Early synergistic interactions between amikacin and six beta-lactam antibiotics against multiply resistant members of the family Enterobacteriaceae.

An in vitro comparison of the early synergistic interaction between amikacin and each of six beta-lactam antibiotics was made by using time-kill curves against 48 multiply resistant members of the family Enterobacteriaceae. Overall, these six combinations demonstrated early synergism (greater than or equal to 2 logs of increased kill after 7 h of incubation) against the 48 strains on 74% (range, 67 to 85%) of occasions; cefotaxime-amikacin and piperacillin-amikacin were the most efficacious combinations. Antagonism was not observed with any of the combinations against any of the 48 Enterobacteriaceae strains tested.