In vitro activities of antimicrobial combinations against clinical isolates of Neisseria gonorrhoeae

Abstract The Centers for Disease Control and Prevention (CDC) now recommend combination therapy with ceftriaxone 250 mg plus azithromycin (AZM) 1 g as a first-line regimen for gonorrhea because the increase of Neisseria gonorrhoeae resistant to multiple antimicrobial agents. However, reports on the...

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Published in:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2013-12, Vol.19 (6), p.1218-1220
Main Authors: Furuya, Ryusaburo, Koga, Yosuke, Irie, Shinichiro, Tanaka, Masatoshi, Ikeda, Fumiaki, Kanayama, Akiko, Kobayashi, Intetsu
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Azithromycin
Azithromycin - pharmacology
Combination
Drug Synergism
Gonorrhea - microbiology
Hematology, Oncology and Palliative Medicine
Humans
Infectious Diseases
Medical Microbiology
Medicine
Medicine & Public Health
Microbial Sensitivity Tests
Neisseria gonorrhoeae
Neisseria gonorrhoeae - drug effects
Neisseria gonorrhoeae - isolation & purification
Spectinomycin
Spectinomycin - pharmacology
Virology
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Summary:Abstract The Centers for Disease Control and Prevention (CDC) now recommend combination therapy with ceftriaxone 250 mg plus azithromycin (AZM) 1 g as a first-line regimen for gonorrhea because the increase of Neisseria gonorrhoeae resistant to multiple antimicrobial agents. However, reports on the in vitro activity of antimicrobial combinations against clinical isolates of N. gonorrhoeae are very rare. In the present study, a checkerboard method was utilized to examine the in vitro activity of ceftriaxone (CTRX), cefodizime (CDZM), spectinomycin (SPCM), or gentamicin (GM) in combination with AZM against 25 clinical isolates of N. gonorrhoeae . The SPCM + AZM combination demonstrated the lowest mean fractional inhibitory concentration index (FICI) of 0.69, followed by the CDZM + AZM combination (mean FICI, 0.75), the CTRX + AZM combination (mean FICI, 0.81), and the GM + AZM combination (mean FICI, 0.83). Additivity/indifference effect was detected for the SPCM + AZM combination, the CDZM + AZM combination, the CTRX + AZM combination, and the GM + AZM combination, against 96 %, 72 %, 92 %, and 100 % of the isolates, respectively. There was no antagonism for any of the antimicrobial combinations against the 25 N. gonorrhoeae isolates. These results suggest that the antimicrobial combinations may be worthy of clinical evaluation as an alternative regimen for gonococcal infections caused by antimicrobial-resistant strains.
ISSN:1341-321X
1437-7780
DOI:10.1007/s10156-013-0597-6