Favourable effect of clavulanic acid on the minimum inhibitory concentrations of cefixime and ceftibuten in ESBL-producing Escherichia coli and Klebsiella pneumoniae.

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  • Additional Information
    • Source:
      Publisher: Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer Country of Publication: Netherlands NLM ID: 101622459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-7173 (Electronic) Linking ISSN: 22137165 NLM ISO Abbreviation: J Glob Antimicrob Resist Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
    • Subject Terms:
      Klebsiella pneumoniae*/drug effects ; Klebsiella pneumoniae*/enzymology ; Escherichia coli*/drug effects ; Escherichia coli*/enzymology ; Microbial Sensitivity Tests* ; Clavulanic Acid*/pharmacology ; Anti-Bacterial Agents*/pharmacology ; beta-Lactamases*/metabolism ; Cefixime*/pharmacology ; Ceftibuten*/pharmacology; Humans ; Klebsiella Infections/microbiology ; Klebsiella Infections/drug therapy ; Escherichia coli Infections/microbiology ; Escherichia coli Infections/drug therapy ; Cephalosporins/pharmacology
    • Abstract:
      Objectives: The use of cephalosporins combined with clavulanate for the treatment of ESBL-harbouring Enterobacteriaceae has been scarcely described. We aimed to describe the effect of different concentrations of clavulanate in the MIC of cefixime and ceftibuten of ESBL-producing Escherichia coli and Klebsiella pneumoniae.
      Methods: ESBL-producing E. coli and K. pneumoniae isolates were studied. Fixed concentrations of cefixime and ceftibuten (ranges of 32-0.25 and 64-0.5 ng/ml, respectively) were used. Combinations of cefixime/clavulanate and ceftibuten/clavulanate in different ratios (1:0, 1:1, 2:1, 4:1, 8:1, 16:1, 32:1) were tested. MIC were determined by broth microdilution.
      Results: A total of 6 ESBL-producing E. coli, 6 ESBL-producing K. pneumoniae and 2 control E. coli were tested. When different quantities of clavulanate were added to cefixime and ceftibuten, greater than two-fold decreases in the MIC were observed. When testing the 1:1 cefixime/clavulanate ratio, 10/12 isolates were susceptible. When the ratios 2:1, 4:1, 8:1 and 16:1 were tested, susceptibility was noted for 9/12, 8/12, 4/12 and 5/12 isolates, respectively. Only 2/12 K. pneumoniae isolates were susceptible when the ratio 32:1 was tested. When testing ceftibuten/clavulanate, all isolates remained susceptible across all experiments.
      Conclusions: Clavulanic acid has a favourable effect in reducing the MIC of cefixime and ceftibuten in isolates of ESBL-producing E. coli and K. pneumoniae. Combining clavulanate with ceftibuten or cefixime could be a useful treatment strategy.
      Competing Interests: Declaration of competing interest The authors declare that they have no competing interests. The authors did not receive direct payments from the sponsor.
      (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
    • Contributed Indexing:
      Keywords: Cefixime; Ceftibuten; Clavulanic acid; Enterobacteriaceae; Extended spectrum beta-lactamase
    • Accession Number:
      23521W1S24 (Clavulanic Acid)
      0 (Anti-Bacterial Agents)
      EC 3.5.2.6 (beta-Lactamases)
      97I1C92E55 (Cefixime)
      IW71N46B4Y (Ceftibuten)
      0 (Cephalosporins)
    • Publication Date:
      Date Created: 20240630 Date Completed: 20240912 Latest Revision: 20240913
    • Publication Date:
      20240914
    • Accession Number:
      10.1016/j.jgar.2024.06.008
    • Accession Number:
      38945364