An in-vitro and in-vivo comparison of the activity of beta-lactamase inhibitor combinations with imipenem and cephalosporins against Escherichia coli producing TEM-1 or TEM-2 beta-lactamase

J Antimicrob Chemother. 1991 Jul;28(1):61-70. doi: 10.1093/jac/28.1.61.

Abstract

Reference strains of Escherichia coli (ampicillin-susceptible and -resistant ATCC strains, and known TEM-1 and TEM-2 beta-lactamase producers) were tested in vitro and in the in-vivo mouse thigh infection model against four beta-lactamase inhibitor compounds (BICs: amoxycillin/clavulanic acid, ampicillin/sulbactam, ticarcillin/clavulanic acid, and piperacillin/tazobactam), selected cephalosporins, and imipenem. The ATCC strains (ampicillin-susceptible and -resistant) were susceptible to the BICs in disc and MIC tests. Three or more logs of killing were observed at the NCCLS breakpoint concentrations. However, the TEM-1 and TEM-2 producers were resistant in disc tests to ampicillin/sulbactam and amoxycillin/clavulanic acid, and showed intermediate susceptibility to ticarcillin/clavulanic acid. MICs were at or near the breakpoint, but bactericidal activity was only noted at the probable breakpoint concentration of piperacillin/tazobactam. Cefoxitin, cefotaxime, cefpirome and imipenem, but not cephalothin, showed greater bactericidal activity and lower MICs for the TEM-producing strains than the BICs. The viable count of the TEM-1 producer was not reduced in the mouse thigh model by ampicillin/sulbactam or amoxycillin/clavulanic acid, but cefpirome and cefotaxime reduced the viable count by approximately three logs. There was a 50% mortality rate in mice receiving the two BICs. The ampicillin-susceptible ATCC strain of E. coli was killed to a similar degree by all agents tested. Overall, the BICs appeared inferior, in both in-vivo and in-vitro tests to selected cephalosporins and imipenem when tested against reference strains of E. coli producing TEM-1 or TEM-2 beta-lactamase. The large inoculum effect and poor bactericidal activity observed with the BICs suggest they could be less effective in certain clinical situations.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Cell Cycle
  • Cephalosporins / pharmacology*
  • Colony Count, Microbial
  • Diffusion
  • Drug Therapy, Combination / pharmacology
  • Escherichia coli / drug effects
  • Escherichia coli / enzymology*
  • Female
  • Imipenem / pharmacology*
  • Mice
  • Microbial Sensitivity Tests
  • beta-Lactamase Inhibitors
  • beta-Lactamases / biosynthesis*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • beta-Lactamase Inhibitors
  • Imipenem
  • beta-Lactamases
  • beta-lactamase TEM-1
  • beta-lactamase TEM-2