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)