Synergistic Activity of Trimethoprim-Sulfamethoxazole on Gram-Negative Bacilli: Observations In Vitro and In Vivo

One hundred seventy-five strains of gram-negative bacillae of the Enterobacteriaceae which cause urinary tract infections were studied for MICs of sulfamethoxazole (SMZ) and trimethoprim (TMP). The synergistic effect of the TMP-SMZ was studied. An extrachromosomal location of genes responsible for r...

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Bibliographic Details
Published in:The Journal of infectious diseases 1973-11, Vol.128 (Supplement-3), p.S470-S477
Main Authors: Seydel, J. K., Acar, J. F., Goldstein, F., Chabbert, Y. A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antibacterials
Bacteria
Child
Dose-Response Relationship, Drug
Drug Resistance, Microbial
Drug Synergism
Enterobacteriaceae - drug effects
Enterobacteriaceae Infections - drug therapy
Escherichia coli
Escherichia coli - drug effects
Escherichia coli K12
Extrachromosomal Inheritance
Female
Genetics, Microbial
Humans
Infections
Klebsiella - drug effects
Male
Microbial Sensitivity Tests
Middle Aged
Recurrence
Relapse
Section I. Laboratory Aspects
Sulfamethoxazole - administration & dosage
Sulfamethoxazole - pharmacology
Sulfamethoxazole - therapeutic use
Sulfonamides
Synergism
Trimethoprim - administration & dosage
Trimethoprim - pharmacology
Trimethoprim - therapeutic use
Urinary tract infections
Urinary Tract Infections - drug therapy
Wild strains
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Summary:One hundred seventy-five strains of gram-negative bacillae of the Enterobacteriaceae which cause urinary tract infections were studied for MICs of sulfamethoxazole (SMZ) and trimethoprim (TMP). The synergistic effect of the TMP-SMZ was studied. An extrachromosomal location of genes responsible for resistance to sulfonamide and to TMP was sought. The synergistic effect of TMP-SMZ was observed in three groups of strains: sulfonamide- and TMP-sensitive strains, sulfonamide-resistant and TMP-sensitive strains, and sulfonamide-resistant, and low-level TMP-resistant strains. Strains belonging to the second and third group transferred their respective drug resistance to Escherichia coli KI2. A fourth group of strains was highly resistant to sulfonamide and TMP. It failed to transfer the resistance to TMP and to show a synergistic effect of TMP-SMZ. Results of treatment with TMP-SMZ in 135 episodes of urinary tract infections showed no difference between patients infected with sulfonamide-sensitive or sulfonamide-resistant strains.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/128.Supplement_3.S470