Effect of rifampicin combination-regimens against multi-drug resistant strains in North India

Abstract

It is well-acknowledged that ‘combination therapy’ of antibiotics is indispensable for the treatment of patients suffering from serious bacterial infections. Therefore, it is of interest to collect data from the in vitro tests using ‘rifampicin-cefotaxime’ and ‘rifampicin-tetracycline’ combination regimens against multi drug resistant Escherichia coli and Klebsiella pneumoniae strains of nosocomial source in order to determine the effectiveness of the combination therapy. The minimum inhibitory concentration (MIC) values for cefotaxime, tetracycline and rifampicin antibiotics were found to be comparatively high for each of the antibiotics when given individually. However, carefully prepared combination-regimens exhibited significant inhibitory effect on the same bacterial isolates. DNA fragmentation study confirmed that ‘rifampicin-cefotaxime’ and ‘rifampicin-tetracycline’ combination-regimens could cause breakage of the bacterial DNA. Thus, we show that combination-regimens namely, ‘rifampicin-cefotaxime’ and ‘rifampicin-tetracycline’ were found to be capable of maintaining rifampicin susceptibility in the E. coli and K. pneumoniae strains. However, this susceptibility was not maintained by only rifampicin. More data using animal model experiments are needed for confirming and deriving translational benefits from these findings in future.