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Influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins against Streptococcus pneumoniae

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Abstract

To study the influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins, 430 consecutive penicillin non-susceptible Streptococcus pneumoniae 2007 isolates received in the Spanish Reference Pneumococcal Laboratory were tested. For comparative purposes, 625 penicillin-susceptible 2007 isolates were also tested. Susceptibility was determined by agar dilution using Mueller-Hinton agar supplemented with 5% sheep blood. Penicillin-susceptible strains were susceptible to amoxicillin, cefotaxime and ceftriaxone, 99.8% to cefpodoxime and 99.5% to cefdinir, and were inhibited by 0.12 μg/ml of cefditoren and 4 μg/ml of cefixime. Penicillin-intermediate strains were susceptible to cefotaxime and ceftriaxone, with <50% susceptibility to cefdinir and cefpodoxime. The MIC50 and MIC90 values of cefditoren were 0.25 μg/ml and 0.5 μg/ml, respectively, whereas cefixime exhibited only marginal activity (MIC90=16 μg/ml). Penicillin-resistant strains were resistant to cefdinir and cefpodoxime, with 74.8% and 94.1% susceptibility to cefotaxime and ceftriaxone, respectively. Cefditoren MIC50/MIC90 (0.5/1 μg/ml) were lower than cefotaxime and ceftriaxone. Among amoxicillin non-susceptible strains, susceptibility to cefdinir and cefpodoxime was <10%, and susceptibility to cefotaxime decreased from 87.9% in the intermediate category to 63.0% in the resistant group. Cefditoren MIC50/MIC90 (0.5/1 μg/ml) were lower than cefotaxime. In conclusion, the activity of cefixime, cefdinir and cefpodoxime was highly affected by penicillin/amoxicillin non-susceptibility, while parenteral third-generation cephalosporins exhibited higher intrinsic activity (MIC90=1 μg/ml for penicillin-resistant and 2 μg/ml for amoxicillin-resistant strains). Cefditoren exhibited one-dilution lower MIC90 values for these strains, even against those of the most troublesome serotypes.

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Acknowledgements

This study was supported by an unrestricted grant from GlaxoSmithKline S.A., Tres Cantos, Madrid, Spain.

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Authors and Affiliations

  1. Spanish National Reference Pneumococcal Laboratory, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo Km. 2, 28220, Majadahonda, Madrid, Spain

    A. Fenoll, O. Robledo & D. Tarragó

  2. Microbiology Department, School of Medicine, University Complutense, Avda. Complutense s/n, 28040, Madrid, Spain

    M. J. Giménez & L. Aguilar

  3. Granadatos SL, c/ Demetrio de la Guerra 4, 28223, Pozuelo de Alarcón, Madrid, Spain

    J. J. Granizo

  4. Medical Department, GlaxoSmithKline S.A., Severo Ochoa 2, 28760, Tres Cantos, Madrid, Spain

    J. E. Martín-Herrero

Authors
  1. A. Fenoll
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  2. M. J. Giménez
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  3. O. Robledo
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  4. L. Aguilar
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  5. D. Tarragó
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  6. J. J. Granizo
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  7. J. E. Martín-Herrero
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Correspondence to L. Aguilar.

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Fenoll, A., Giménez, M.J., Robledo, O. et al. Influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins against Streptococcus pneumoniae . Eur J Clin Microbiol Infect Dis 27, 75–80 (2008). https://doi.org/10.1007/s10096-007-0402-5

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  • DOI: https://doi.org/10.1007/s10096-007-0402-5

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