In Vitro Responses of Acinetobacter baumannii to Two- and Three-Drug Combinations following Exposure to Colistin and Doripenem |
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| Authors: | Louise M. Oleksiuk M. Hong Nguyen Ellen G. Press Cassaundra L. Updike Jessica A. O'Hara Yohei Doi Cornelius J. Clancy Ryan K. Shields |
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| Affiliation: | aAntibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA ;bDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA ;cVA Healthcare System Pittsburgh, Pittsburgh, Pennsylvania, USA |
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| Abstract: | We compared in vitro killing of colistin, doripenem, and sulbactam by time-kill methods against Acinetobacter baumannii isolates collected from patients before and after colistin-doripenem treatment (initial and recurrent isolates, respectively). Colistin-doripenem bactericidal activity against recurrent isolates was attenuated (mean log10 kill, −5.74 versus −2.88; P = 0.01) but was restored by adding sulbactam. Doripenem MICs rather than colistin MICs correlated with the activity of colistin-doripenem. Among colistin-resistant isolates, colistin-doripenem-sulbactam combinations achieved greater killing than colistin-doripenem alone (−5.65 versus −2.43; P = 0.04). |
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