Comparative susceptibilities of 173 aerobic and anaerobic bite wound isolates to sparfloxacin, temafloxacin, clarithromycin, and older agents

Abstract

The in vitro activities of sparfloxacin, temafloxacin, ciprofloxacin, ofloxacin, clarithromycin, erythromycin, tetracycline, cephalothin, penicillin G, and amoxicillin-clavulanic acid against 173 recent clinical bite wound isolates were determined by agar dilution. Sparfloxacin was active against all strains (MIC for 90%o of strains tested, c1 ,ug/ml) except for most fusobacteria and one-third of the Prevotela spp. The other fluoroquinolones had similar activities but higher MICs, especially for streptococci. Clarithromycin was more active against many isolates including Pasteureffa mulocida than erythromycin, with MICs of .2 iLg/ml (versus 4 ,ug/mi for erythromycin).Since many laboratories are unable to perform in vitro susceptibility studies with fastidious aerobic and anaerobic bacteria, clinicians must sometimes rely on the medical literature to guide therapeutic choices, both empiric and specific, for human and animal bite wounds. Prior studies (3,6,8,9) have noted a high percentage of 3-lactamaseproducing bacteria and the emergence of resistance to commonly used antimicrobial agents in several genera of isolates obtained from bite wounds. Consequently, information about newer alternative therapeutic agents and their in vitro activities against the full spectrum of species isolated from bite wounds is needed to help guide therapeutic choices.The use of fluoroquinolones, such as ciprofloxacin and ofloxacin (6,16), for treating bite wound infections has been considered. They have been noted to be active against the aerobic but not many of the anaerobic bacteria isolated from human and animal bite wounds (6, 16). Consequently, there is interest in the potential utility of other quinolones. Sparfloxacin (AT-4140, RP 64206, and PD 131501) is a new fluoroquinolone agent that has an expanded spectrum of activity against aerobic and anaerobic bacteria (1, 4, 7). Temafloxacin, recently voluntarily removed from the market by its manufacturer, was also considered potentially useful in bite wound therapy (5, 7, 10). Erythromycin, while suboptimally active against Pasteurella multocida, must sometimes be used, albeit cautiously, for the treatment of bite wound infections in multidrug-allergic patients, children, and pregnant women. Clarithromycin, a new macrolide, has been noted to have improved pharmacokinetics and in vitro activity compared with those of erythromycin (11,15).Consequently, we determined the comparative susceptibilities of 112 aerobic and 61 anaerobic bite wound isolates to these new antimicrobial agents and compared the activities of these new drugs with those of older agents.All bacteria studied (Table 1) were recent clinical isolates and were identified by standard criteria (2,12,14,18 Strains were taken from frozen stock cultures and transferred twice to ensure purity and good growth. Bacteria were tested by standard procedures by the appropriate methods for the particular organism as previously described (6). Brucella blood agar supplemented with hemin, vitamin K1, and 5% laked sheep blood was the ...

Comparative in vitro activities of azithromycin, Bay y 3118, levofloxacin, sparfloxacin, and 11 other oral antimicrobial agents against 194 aerobic and anaerobic bite wound isolates

“…The other agents studied exhibited susceptibility patterns similar to those noted in prior reports (6)(7)(8)(9)(10). Doxycycline was active against most aerobic and anaerobic isolates, with the exception of streptococci and peptostreptococci.…”

“…Several fluoroquinolones, such as ciprofloxacin, ofloxacin, and sparfloxacin, have been previously noted to possess in vitro activity against some bite wound isolates, including P. multocida (7,8). In our current study, sparfloxacin and levofloxacin were active against all aerobic isolates at Յ0.25 g/ml, except for streptococci, for which the MIC at which 90% of the isolates are inhibited (MIC 90 ) was 1.0 g/ml.…”

“…Previous studies have shown erythromycin to have limited activity against bite isolates, especially P. multocida (8,9). While roxithromycin has been even less active on a weight basis than erythromycin (10), clarithromycin was reported as more active, with a MIC 90 of 2 g/ml against P. multocida (8).…”

Bacteriologic Analysis of Infected Dog and Cat Bites

“…Pasteurella species are usually susceptible to ampicillin, penicillin, second-generation and thirdgeneration cephalosporins, doxycycline, trimethoprim-sulfamethoxazole, fluoroquinolones, clarithromycin, and azithromycin. [37][38][39][40][41][42][43] Antibiotics typically used for routine infections of skin and soft tissue, such as antistaphylococcal penicillins, first-generation cephalosporins, clindamycin, and erythromycin, are less active against pasteurella in vitro. In this study, treatment with first-generation cephalosporins alone was unsuccessful in three cases in which pasteurella was cultured.…”

Animal related facial trauma

“…34,35 Therefore, the prophylactic antibiotic should be a broad spectrum antibiotic, in which case co-amoxiclav seems to be a drug of choice. 36 The alternative prophylaxis for patients allergic to penicillin include tetracyclines, a second generation of cephalosporin with anaerobic activity, or combination therapy with clindamycin and fluoroquinolone. 31 In the case of bite wounds, there is a threat of inflammatory complications, so careful debridement of necrotic tissue and wound toilet are always required.…”