Postantibiotic effect of ceftriaxone and gentamicin alone and in combination on Klebsiella pneumoniae, Pseudomonas aeruginosa and Streptococcus viridans.

A persistent suppression of bacterial growth following limited exposure to an antimicrobial agent, the postantibiotic effect (PAE), has been described for a variety of antibiotics and microorganisms. In this study the PAE of ceftriaxone and gentamicin was determined in vitro on three strains each of Klebsiella pneumoniae, Pseudomonas aeruginosa and Streptococcus viridans. The strains were exposed to the substances for 2 h at varying concentrations. Ceftriaxone was used at the minimal inhibitory concentration (MIC) and 1/2 MIC and gentamicin at 1/2 MIC, 1/4 MIC, and 1/8 MIC, each alone and in combination. Antibiotic concentrations were reduced by 1,000-fold dilution, bacterial regrowth was consequently monitored by viable count. The PAE of ceftriaxone alone reached up to 145 min (MIC) and 50 min (1/2 MIC), that of gentamicin alone up to 170 min (1/2 MIC), 135 min (1/4 MIC) and 70 min (1/8 MIC), depending on the bacterial species. Combinations of the antibiotics produced longer PAEs than one substance alone; the longest PAE was produced by the combination of ceftriaxone (MIC) and gentamicin (1/2 MIC) lasting up to 320 min (S. viridans). It may be important to take the PAE into account when evaluating dosing intervals.