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In vitro bactericidal activity of amoxicillin combined with different cephalosporins against endocarditis-associated Enterococcus faecalis clinical isolates

Abstract : Background - The combination of amoxicillin with cefazolin could be an interesting regimen for the empirical therapy of severe infective endocarditis, but its activity against enterococci is unknown. Objectives - To evaluate in vitro the bactericidal activity of the combination of amoxicillin with different cephalosporins including cefazolin. Methods - Combinations of amoxicillin (at MIC×¼) with cefazolin, cefotaxime, ceftriaxone, cefepime, ceftaroline or ceftobiprole (at the mean free plasma concentration) were studied using time-kill experiments for 10 endocarditis-associated Enterococcus faecalis strains and 2 reference strains. Results - The combinations amoxicillin/cefazolin, amoxicillin/cefotaxime, amoxicillin/ceftriaxone and amoxicillin/cefepime were synergistic at 12 and 24 h against 12/12 strains and amoxicillin/ceftobiprole and amoxicillin/ceftaroline against 10/12 strains. The combination amoxicillin/cefepime was bactericidal at 24 h against 9/12 strains, the combination amoxicillin/cefazolin against 8/12 strains, the combinations amoxicillin/ceftaroline, amoxicillin/cefotaxime and amoxicillin/ceftobiprole against 7/12 strains and the combination amoxicillin/ceftriaxone against 6/12 strains. Conclusions - The combination amoxicillin/cefazolin is as synergistic and bactericidal in vitro as amoxicillin/cefotaxime or amoxicillin/ceftriaxone against E. faecalis.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-02307173
Contributor : Laurent Jonchère <>
Submitted on : Monday, October 7, 2019 - 1:25:28 PM
Last modification on : Thursday, April 9, 2020 - 11:57:57 AM

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Nathan Peiffer-Smadja, Elena Guillotel, David Luque-Paz, Naouale Maataoui, F-Xavier Lescure, et al.. In vitro bactericidal activity of amoxicillin combined with different cephalosporins against endocarditis-associated Enterococcus faecalis clinical isolates. Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), 2019, 74 (12), pp.3511-3514. ⟨10.1093/jac/dkz388⟩. ⟨hal-02307173⟩

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