Lack of in vitro activity of cefoxitin, cefamandole, cefuroxime, and piperacillin against Chlamydia trachomatis

Bowie, William

doi:10.1128/aac.21.2.339

Cited by 10 publications

(3 citation statements)

References 10 publications

(8 reference statements)

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“…In contrast, with penicillins there are occasional inclusions over a wide range of concentrations (6,10,14,15). This probably accounts for the large discrepancies in published reports of MICs of penicillins (4,6,9,10,(13)(14)(15)(16). In vivo, single-dose penicillin treatment does not usually eradicate C. trachomatis (7, 10), but multiple-dose penicillin treatment often results in negative follow-up cultures for weeks or longer (2,5,7,12).…”

contrasting

confidence: 44%

In vitro activity of clavulanic acid, amoxicillin, and ticarcillin against Chlamydia trachomatis

Bowie¹

1986

Antimicrob Agents Chemother

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In vitro, growth of Chlamydia trachomatis was not entirely eliminated by 960 ,ig of ticarcillin per ml, 64 ,ug of amoxicillin per ml, 32 ,ug of clavulanic acid per ml, a combination of ticarcillin (480 ,ig/ml) and clavulanic acid (32 ,ig/ml), and a combination of amoxicillin (32 ,ig/ml) and clavulanic acid (8 ,ig/ml). However, a -99% decrease in the number of inclusions was obtained at concentrations readily attainable in serum.Penicillins have partial activity against Chlamydia trachomatis both in vitro and in vivo (2-7, 9, 16). For most antimicrobial agents, MICs are well defined and the number of inclusions in cell cultures declines dramatically from numbers near those in controls without antimicrobial agents to nil over only a few dilutions (6,10,14,15). In contrast, with penicillins there are occasional inclusions over a wide range of concentrations (6,10,14,15). This probably accounts for the large discrepancies in published reports of MICs of penicillins (4,6,9,10,(13)(14)(15)(16). In vivo, single-dose penicillin treatment does not usually eradicate C. trachomatis (7, 10), but multiple-dose penicillin treatment often results in negative follow-up cultures for weeks or longer (2,5,7,12). Because of this activity, penicillins have been considered for use in the treatment of uncomplicated chlamydial infections in pregnancy (2). Clavulanic acid, in combination with amoxicillin or ticarcillin, has been used in the treatment of genital syndromes or infections such as the frequencydysuria syndrome and pelvic inflammatory disease (1,8) that are sometimes caused by C. trachomatis (11,17). Consequently, it is important to know whether the addition of clavulanic acid to amoxicillin or ticarcillin enhances in vitro activity against C. trachomatis. In this study, the activities of amroxicillin, ticarcillin, and clavulanic acid alone, clavulanic acid in combination with amoxicillin, and clavulanic acid in combination with ticarcillin were evaluated in vitro against C. trachomatis in cell cultures.Twenty-one strains of C. trachomatis were used, including three typed strains (B, DE, and FG) initially isolated from men with nongonococcal urethritis in Seattle, Wash., one LGV2 strain kindly provided by Julius Schachter, and 17 genital isolates from men and women in Vancouver or Edmonton, Alberta, Canada. Isolates were passed in cycloheximide-treated McCoy cells and stored at -70°C when not in use. All strains were in passage 7 to 10 at the time of use.Antimicrobial agents were reconstituted and diluted with 0.4 M sucrose phosphate the day of use (6, 15). The final concentrations evaluated for ticarcillin were 960, 480, 30, 7.5, 1.875, and 0.469 ,uggml; for amoxicillin they were 64, 16, 4, 1, and 0.25 ,ug/ml; for clavulanic acid they were 32, 16, 4, 1, and 0.25 ,ug/ml; for the combination of ticarcillin and clavulanic acid in a 15:1 ratio they were 480 and 32, 30 and 2, 7.5 and 0.5, 1.875 and 0.125, and 0.469 and 0.031 p.g/ml;and for the combination of amoxicillin with clavulanic acid in a 4:1 ratio they were 32 and 8, 8 an...

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confidence: 44%

In vitro activity of clavulanic acid, amoxicillin, and ticarcillin against Chlamydia trachomatis

Bowie¹

1986

Antimicrob Agents Chemother

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“…The most active drug was mecillinam, which had a mean MIC of 0.45 ,ug/ml and an MCC of 0.5 jxg/ml. Overall, our results agree closely with those of previous studies (1,3,5,6,7), with the exception of piperacillin. Bowie (1) reported piperacillin MICs of .4,096 ,ug/ml by methods, including iodine staining, very similar to ours.…”

supporting

confidence: 83%

In vitro activity of a group of broad-spectrum cephalosporins and other beta-lactam antibiotics against Chlamydia trachomatis

Hammerschlag¹,

Gleyzer²

1983

Antimicrob Agents Chemother

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The activities of seven broad spectrum cephalosporins, four other ,-lactam antibiotics, and one monobactam against Chlamydia trachomatis were measured in a cell culture system. The minimal inhibitory concentration offour of the seven cephalosporins was .-128 ,ug/ml; those of the other three were from 16 to 32 ,ug/ml. Of the other agents, only mecillinam had activity against C. trachomatis comparable to that reported for ampicillin (minimal inhibitory concentration, <0.5 ,ug/ml).A single dose of penicillin or ampicillin as commonly used in the treatment of uncomplicated gonococcal urethritis will usually not eradicate a concurrent chlamydial infection (5). Repetitive dosage is more effective; thus, amoxicillin given for 10 days eradicated Chlamydia trachomatis in 48% of men with chlamydial urethritis (2) and, given for 14 days, eradicated these organisms from the cervixes of pregnant women (E. R. Alexander, personal communication). To assess the potential activity of other ,Blactam antibiotics, we tested seven of the new broad-spectrum cephalosporins, four other Plactam antibiotics, and one monobactam against five C. trachomatis strains in a cell culture system.McCoy cells treated with cycloheximide were used. The cells were grown in Eagle minimal essential medium to which 10% inactivated fetal calf serum, 2 mM glutamine, and 5% glucose were added. No antibiotics or antifungal agents except those under investigation were included in the medium. Seven-day-old monolayers were treated with trypsin and resuspended in medium to a concentration of 3 x 10 cells per ml. The cells were seeded onto 96-well microtiter plates with a volume of 0.2 ml per well and incubated at 35°C for 24 h.One isolate of C. trachomatis, H/UW-4, which is well adapted to conditions in the laboratory; four clinical isolates from patients with urethritis, neonatal conjunctivitis, and from the cervix were used in our studies. These isolates had been passed three to five times in cells free of antibiotics.The antimicrobial agents evaluated were moxalactam, cefmenoxime, cefotaxime, ceftriaxone, cefoperazone, N-formimidoyl thienamycin, cefsulodin, mecillinam, piperacillin, mezlocillin, azlocillin, and the monobactam Sch 29,482. Sch 29,482, an oral penem highly resistant to J-lactamase, has been reported to be highly active against both ,-lactamase-positive and -negative strains of Neisseria gonorrhoeae and Haemophilus influenzae (C. Thornsberry and C. N. Baker, Program Abstr. Intersci. Conf. Antimicrob. Agents Chemother. 21st, Chicago, Ill., abstr. no. 747, 1981).The various antimicrobial agents were supplied as powders, solubilized according to instructions from the manufacturer, and diluted in medium containing 2 j±g of cycloheximide per ml before use. One-day-old monolayers were inoculated with 0.1 ml of the test strain dilution to yield 103 to 104 inclusion-forming units per ml.The plates were then centrifuged for 60 min at 2,000 x g at 25°C. After inoculation and centrifugation, the medium was aspirated and the wells were overlaid with 0.2-ml p...

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“…Penicillins have been reported to eradicate C. trachomatis in eight of ten women treated with a 21-day course of ampicillin for cervical and/or urethral infection. 8 Bowie et al reported the microbiological cure in six of six men with urethritis when treated with a 10-day regimen of amoxicillin. 9 Martin et al reported the microbiological cure of C. trachomatis infection in seven patients treated with ticarcillin/clavulanic acid, whereas three patients treated with cephalosporins remained culture positive after treatment.…”

mentioning

confidence: 99%

In Vitro Susceptibility Testing of Clinical Isolates of Chlamydia trachomatis

Martens

Faro²,

Maccato³

et al. 1993

Infectious Diseases in Obstetrics and Gynecology

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Penicillin class antibiotics have demonstrated varying degrees of in vivo and in vitro success when tested against Chlamydia trachomatis. The activity of ampicillin-sulbactam, an agent commonly utilized in the treatment of pelvic infections, was tested to ascertain if any antichlamydial activity is present. Up to six endocervical isolates of C. trachomatis were tested against each of five antibiotics including doxycycline, erythromycin, clindamycin, ampicillin/sulbactam, and sulbactam alone. McCoy cell monolayers were inoculated with high inclusion counts of 10,000–30,000 inclusion-forming units (IFU) per coverslip, and exposed to each antibiotic. Up to nine subsequent antibiotic free culture passes were performed to assess the viability of abnormal inclusions. Doxycycline, erythromycin, and clindamycin achieved 100% eradication of inclusions at concentrations of 4.0, 2.0, and 1.0 µg/mL. Exposure to ampicillin/sulbactam resulted in a greater than 99% reduction in the inclusion count at 32.0 µg/mL, while sulbactam by itself demonstrated considerably less activity. Abnormal inclusions were noted only in the ampicillin/sulbactam exposed cells, and these, plus all inclusions remaining following sublethal exposure to the other antibiotics, resulted in regrowth to control levels in subsequent passes. Doxycycline and erythromycin demonstrated excellent activity. Clindamycin and ampicillin/sulbactam also significantly reduced inclusion formation, and therefore may provide adequate C. trachomatis coverage in patients receiving these antibiotics for pelvic infections.

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Lack of in vitro activity of cefoxitin, cefamandole, cefuroxime, and piperacillin against Chlamydia trachomatis

Cited by 10 publications

References 10 publications

In vitro activity of clavulanic acid, amoxicillin, and ticarcillin against Chlamydia trachomatis

In vitro activity of clavulanic acid, amoxicillin, and ticarcillin against Chlamydia trachomatis

In vitro activity of a group of broad-spectrum cephalosporins and other beta-lactam antibiotics against Chlamydia trachomatis

In Vitro Susceptibility Testing of Clinical Isolates of Chlamydia trachomatis

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