Table 1. Comparative activity of antimicrobial agents against B. fragilis group species*
|
|
B. fragilis |
B. distasonis |
B. thetaiotamicron |
B. ovatus |
B. vulgatus |
||||||||||
Antibiotic |
NCCLS breakpointsH (S, I) |
MIC50 |
MIC90 |
Range |
MIC50 |
MIC90 |
Range |
MIC50 |
MIC90 |
Range |
MIC50 |
MIC90 |
Range |
MIC50 |
MIC90 |
Range |
Ticarcillin |
(32, 64) |
32 |
128 |
NA |
128 |
128 |
NA |
64 |
128 |
NA |
64 |
128 |
NA |
32 |
128 |
NA |
Piperacillin |
(32, 64) |
16 |
256 |
NA |
64 |
128 |
NA |
32 |
128 |
NA |
32 |
128 |
NA |
64 |
128 |
NA |
Cefoxitin |
(16, 32) |
8 |
32 |
2 - 256 |
16 |
32 |
4 - 256 |
8 |
16 |
1 - 256 |
8 |
16 |
2 - 64 |
4 |
16 |
2 - 64 |
Cefotetan |
(16, 32) |
8 |
64 |
2 - 256 |
128 |
256 |
4 - 256 |
64 |
256 |
1 - 256 |
64 |
128 |
2 - 128 |
4 |
128 |
2 - 256 |
Ceftizoxime |
(16, 32) |
64 |
128 |
4 - 256 |
32 |
256 |
1 - 256 |
64 |
256 |
1 - 256 |
32 |
256 |
4 - 256 |
16 |
128 |
1 - 256 |
Imipenem |
(4, 8) |
0.5 |
0.5 |
0.015 - 4 |
0.06 |
0.25 |
0.015-0.25 |
0.5 |
1 |
0.03 - 4 |
0.125 |
0.25 |
0.015-0.5 |
0.25 |
0.5 |
0.015-0.5 |
Meropenem |
(4, 8) |
0.5 |
0.5 |
0.015 - 4 |
0.06 |
0.25 |
0.015-0.25 |
0.5 |
1 |
0.03 - 4 |
0.125 |
0.25 |
0.015-0.5 |
0.25 |
0.5 |
0.015-0.5 |
Amox /Clavulanate |
(4, 8) |
1 |
4 |
0.25 - 4 |
2 |
32 |
0.125-32 |
1 |
2 |
0.125 - 4 |
2 |
8 |
0.25 - 16 |
2 |
8 |
0.25 - 8 |
Ampicillin/Sulbactam |
(8, 16) |
2 |
8 |
NA |
8 |
32 |
NA |
4 |
16 |
NA |
4 |
16 |
NA |
4 |
16 |
NA |
Piperacillin/Tazobactam |
(32, 64) |
0.5 |
4 |
NA |
8 |
32 |
NA |
8 |
16 |
NA |
8 |
16 |
NA |
8 |
16 |
NA |
Ticarcillin/Clavulanate |
(32, 64) |
1 |
8 |
NA |
16 |
64 |
NA |
4 |
16 |
NA |
4 |
16 |
NA |
2 |
8 |
NA |
Clindamycin |
(2, 4) |
0.5 |
128 |
0.06-128 |
2 |
128 |
0.06-128 |
4 |
128 |
0.06-128 |
2 |
128 |
0.06-128 |
0.06 |
128 |
0.03-128 |
Chloram - phenicol& |
(8, 16) |
1 |
8 |
NA |
1 |
8 |
NA |
1 |
8 |
NA |
1 |
8 |
NA |
1 |
8 |
NA |
Metronidazole |
(8, 16) |
0.5 |
0.5 |
0.25 - 1 |
0.5 |
0.5 |
0.25 - 1 |
0.5 |
1 |
0.25 - 1 |
0.5 |
1 |
0.25 - 1 |
0.5 |
0.5 |
0.25 - 1 |
Trovafloxacin |
(2, 4) |
0.25 |
2 |
0.25 - 2 |
0.5 |
1 |
0.125 - 1 |
0.5 |
2 |
0.25 - 4 |
1 |
2 |
0.125 - 2 |
0.25 |
4 |
0.125 - 4 |
* Data based upon various published studies; H, S, I; Susceptible and intermediate breakpoints in μg/ml; I, Not available; &, Drug tested only at screening dilutions
Table 2. Comparative
antimicrobial trials for treatment of intra-abdominal and pelvic infections.
Intra-abdominal
Cefoxitin + amino glycoside vs. clindamycin + amino glycoside (29,79,115)
Ceftizoxime vs. cefoxitin (7)
Piperacillin vs. cefoxitin (71)
Ampicillin/sulbactam vs. clindamycin + amino glycoside (108)
Imipenem vs. clindamycin + amino glycoside (98,105)
Aztreonam + clindamycin vs. clindamycin + amino glycoside (8,129)
Aztreonam + clindamycin vs. imipenem (26)
Ticarcillin/clavulanate vs. clindamycin amino glycoside (40)
Piperacillin/tazobactam vs. imipenem (9)
Piperacillin/tazobactam vs. clindamycin + amino glycoside (89)
Meropenem vs. clindamycin + tobramycin (22)
Meropenem vs. cefotaxime + metronidazole (63)
Pelvic
Piperacillin vs. cefoxitin (112)
Piperacillin vs. clindamycin + gentamicin (43)
Piperacillint/tazobactam vs. clindamycin + gentamicin (113)
Ampicillin/sulbactam vs. clindamycin (67)
Imipenem vs. clindamycin gentamicin (66)
Meropenem vs. clindamycin gentamicin (54)