Synergistic Action of Erythromycin and Cefamandole Against Bacteroides fragilis Subsp. fragilis

Erythromycin and cefamandole have exhibited synergistic activity against eight strains of Bacteroides fragilis subsp. fragilis. In concentrations of only 0.25 to 0.5 μg of erythromycin per ml (easily obtainable with oral therapy), less than 0.4 μg (0.015 to 1.0) of cefamandole per ml inhibited the B. fragilis strains. In the presence of the erythromycin, the potency of cefamandole was increased more than 100-fold. On the basis of the mechanism of action of these two antibiotics, the synergism may be related to inhibition of beta-lactamase formation by the erythromycin, removal of the bacterial cell wall by the cefamandole permitting erythromycin penetration to the ribosomal level, and decreasing inoculum effect.

[1]  H. Black,et al.  Cefamandole: In Vitro and Clinical Pharmacokinetics , 1976, Antimicrobial Agents and Chemotherapy.

[2]  R. Quintiliani,et al.  Synergism of Cefazolin-Gentamicin Against Enterococci , 1976, Antimicrobial Agents and Chemotherapy.

[3]  Ronald N. Jones,et al.  Identification and Antimicrobial Susceptibility of 250 Bacteroides fragilis Subspecies Tested by Broth Microdilution Methods , 1976, Antimicrobial Agents and Chemotherapy.

[4]  D. Busch,et al.  Activity of combinations of antimicrobial agents against Bacteroides fragilis. , 1976, The Journal of infectious diseases.

[5]  E. Stokes.  Anaerobic Bacteria: Role in Disease , 1975 .

[6]  R. Perkins,et al.  Microdilution Technique for Antimicrobial Susceptibility Testing of Anaerobic Bacteria , 1975, Antimicrobial Agents and Chemotherapy.

[7]  J. Ryan,et al.  Simple method for culturing anaerobes. , 1973, Applied microbiology.

[8]  E. Chappelle,et al.  An automated luciferase assay of bacteria in urine , 1971 .

[9]  K. Holmes.  THE PATHOGENIC ANAEROBIC BACTERIA , 1970 .

[10]  G. V. Levin,et al.  Use of the firefly bioluminescent reaction for rapid detection and counting of bacteria , 1968 .

[11]  P. P. Williams.  Dispensing Apparatus for Controlling Eh, pH, and Volume of Anaerobic Bacterial and Protozoal Culture Media , 1966 .

[12]  S. Seligman,et al.  Kinetics of the synergism of penicillin-streptomycin and penicillin-kanamycin for enterococci and its relationship to L-phase variants. , 1966, The Journal of laboratory and clinical medicine.

[13]  Lillian V. Holdeman,et al.  Anaerobe Laboratory manual , 1977 .

[14]  R. Weinstein,et al.  Comparison of methods for assessing in vitro antibiotic synergism against Pseudomonas and Serratia. , 1975, The Journal of laboratory and clinical medicine.

[15]  Ernest Frederick Gale,et al.  The Molecular basis of antibiotic action , 1972 .

[16]  W. Farrar,et al.  Antimicrobial therapy of infections due to anaerobic bacteria. , 1972, Seminars in drug treatment.

[17]  L. Sabath.  Synergy of antibacterial substances by apparently known mechanisms. , 1967, Antimicrobial agents and chemotherapy.

[18]  H. Black,et al.  A comparison of blood levels after oral administration of erythromycin and erythromycin estolate. , 1962, Antibiotics & chemotherapy.