In vitro activities of teichomycin, fusidic acid, flucloxacillin, fosfomycin, and vancomycin against methicillin-resistant Staphylococcus aureus

Guenthner, Sharon H.; Wenzel, Richard P.

doi:10.1128/aac.26.2.268

Cited by 31 publications

(25 citation statements)

References 21 publications

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“…It is active in vitro against Staphylococcus aureus, Clostridium spp., and corynebacteria (8,10,23). Its antibacterial activity is the result of an inhibition of bacterial protein synthesis (1).…”

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confidence: 99%

Pharmacokinetics of intravenous fusidic acid in patients with cholestasis

Peter

Jehl

Pottecher

et al. 1993

Antimicrob Agents Chemother

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The pharmacokinetics of fusidic acid and 3-ketofusidic acid were investigated in cholestatic and noncholestatic patients after intravenous administration of single and multiple doses of 500 mg of sodium fusidate. The patients, all with low serum albumin levels, were divided into three groups. Group I consisted of six noncholestatic patients; group II consisted of nine mildly cholestatic patients with mild hepatic impairment (conjugated bilirubin, 47 pmol liter-l; alkaline phosphatase, 280 IU liter-'; y-tglutamyltranspeptidase, 190 IU liter-.); group m consisted of six benign intrahepatic cholestatic patients with high isolated conjugated hyperbilirubinemia (98.1 ,umol liter-'). Assays were performed by high-pressure liquid chromatography. At steady state, the mean peak concentrations in serum were 63.7, 44.9, and 92.2 tLg ml-l in groups I, II, and III, respectively; over a dosage interval, areas under the concentration-time curve were 411. 1, 238.7, and 603.4 t.g. h ml-' and the mean body clearances were 0.34, 0.53, and 0.25 ml min kg-' in groups I, II, and III, respectively. The accumulation ratio of fusidic acid increased from 2.8 and 2.4 in groups I and II to 4.2 in group II. At steady state, the ratios of the areas under the concentration-time curve from 0 to 8 h for 3-ketofusidic acid/fusidic acid were 0.11, 0.09, and 0.10 in the three groups, respectively. Only very small amounts of fusidic acid and 3-ketofusidic acid were found in urine. These results substantiate the following hypotheses. In group I and II patients the clearance is higher than that in healthy volunteers because of the increased free, unbound fraction of fusidic acid, a consequence of lower serum albumin concentrations, resulting in increased distribution in tissue and hepatic metabolism. In group MII patients, the higher bilirubinemia results in competition with fusidic acid for the limited glucuronidation mechanism, thus compensating for the increased elimination of fusidic acid because of the low serum albumin concentration. These results suggest that fusidic acid can be administered normally even to patients with high bilirubinemia because the postoperative serum albumin concentration is usually low.

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confidence: 99%

Pharmacokinetics of intravenous fusidic acid in patients with cholestasis

Peter

Jehl

Pottecher

et al. 1993

Antimicrob Agents Chemother

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“…It shows in vitro activity against S. aureus spp., including penicillin-and methicillin-resistant strains (5,9). It has little or no reported toxicity to serum proteins and does not bind to them (6,7).…”

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confidence: 99%

In vitro activity of fosfomycin, alone and in combination, against methicillin-resistant Staphylococcus aureus

Álvarez¹,

Jones²,

Berk³

1985

Antimicrob Agents Chemother

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We tested 148 strains of clinical isolates of methicillin-resistant Staphylococcus aureus against fosfomycin alone and in combination with methicillin, cefamandole, gentamicin, trimethoprim, and vancomycin. Fosfomycin inhibited 90% of the 148 methicillin-resistant S. aureus strains at a concentration of 4 ,ug/ml. Synergism was observed in 97 strains (66%) with fosfomycin-cefamandole and in 69 strains (46%) with fosfomycin-methicillin. The combinations of fosfomycin with vancomycin, gentamicin, and trimethoprim were indifferent in most strains.

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“…It acts by blocking acetylmuramic acid synthesis and has a broad spectrum of activity against gram-positive and gram-negative organisms. No cross-resistance with other antimicrobial agents has been reported (Guenther & Wenzel, 1984). It has a serum half-life of 2 h (Hutzler et al 1977).…”

Section: Discussionmentioning

confidence: 99%

“…However, clinical experience of treating serious staphylococcal infection with rifampicin and trimethoprim-sulphamethoxazole is limited (Guenther & Wenzel, 1984) and fully resistant organisms may emerge rapidly after exposure to fusidic acid in vitro and in vivo (Watanakunakorn, 1983). As vancomycin shows good activity in vitro and in vivo it has been regarded as the drug of choice (Myers & Linneman, 1982;Watanakunakorn, 1982Watanakunakorn, , 1983.…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo study of fosfomycin in methicillin-resistant Staphylococcus aureus septicaemia

Lau

Teoh-Chan

Fan

et al. 1986

J. Hyg.

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SUMMARYFive hundred strains of methicillin-resistant Staphylococcus aureus were tested against various anti-staphylococcal agents. Vancomycin, fusidic acid and fosfomycin were found to be the most effective. Only 1 strain out of 500 was resistant to fosfomycin. Three patients with methicillin-resistant Staphylococcus aureus septicaemia were successfully treated by fosfomycin. We conclude that fosfomycin could be the drug of choice for methicillin-resistant Staphylococcus aureus infection.

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In vitro activities of teichomycin, fusidic acid, flucloxacillin, fosfomycin, and vancomycin against methicillin-resistant Staphylococcus aureus

Cited by 31 publications

References 21 publications

Pharmacokinetics of intravenous fusidic acid in patients with cholestasis

Pharmacokinetics of intravenous fusidic acid in patients with cholestasis

In vitro activity of fosfomycin, alone and in combination, against methicillin-resistant Staphylococcus aureus

In vitro and in vivo study of fosfomycin in methicillin-resistant Staphylococcus aureus septicaemia

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