Journal
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 68, Issue 4, Pages 827-830Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jac/dks472
Keywords
Gram-negatives; bacterial biofilms; catheter-related infections; antibiotic therapy; polymyxin B
Funding
- Research Fund of the University of Istanbul [4566]
Ask authors/readers for more resources
Objectives: To determine the in vitro stability and efficacy of colistin, tigecycline and levofloxacin alone or in combination with clarithromycin and/or heparin as lock solutions against biofilm-embedded Acinetobacter baumannii strains. Methods: Candidate antibiotics (colistin, tigecycline and levofloxacin) were investigated in vitro, either alone or in combination with clarithromycin and/or heparin in solution. The efficacy of antibiotic lock solutions was tested in an in vitro catheter biofilm model against A. baumannii isolated from catheter-related bacteraemia. Results: Candidate antibiotics at 400x MICs combined with clarithromycin (200 mg/mL) and/or heparin (1000 U/mL) were compatible. Colistin, tigecycline and levofloxacin and their combinations with clarithromycin demonstrated bactericidal activity against the biofilm-embedded A. baumannii strains. Compared with other antibiotics alone, the lock solution including only colistin was the best agent to eradicate A. baumannii embedded in the catheter model. When tested antibiotics were used in combination with clarithromycin, the combinations were significantly more effective and more rapid in reducing the live cell number or eliminating A. baumannii colonization in biofilms than each of the antibiotics alone. Conclusions: Catheter lock solutions containing colistin may have the most promise for treating or preventing biofilm-producing catheter infections caused by A. baumannii. Clarithromycin was ultimately effective with the studied antibiotics to reduce live cell number or eradicate A. baumannii colonization in biofilms and could serve as an antibiotic enhancer. Our in vitro model findings now warrant clinical trials to investigate their real role in the management of catheter-related bacteraemia.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available