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Clarithromycin enhances the effect of piperacillin/tazobactam in an experimental model of empyema by multidrug-resistant Pseudomonas aeruginosa

Abstract number: 1733_1261

Tsaganos T., Adamis T., Txepi I., Tsovolou I., Zografos G., Giamarellou H., Giamarellos-Bourboulis E.

Objective: Clarithromycin (CL) is considered to present immunomodulatory properties for chronic inflammatory disorders of the lung. Its effect was tested in combination with piperacillin/tazobactam (PT) in experimental pleuritis by multidrug-resistant P. aeruginosa (MDRPA).

Methods: 0.3 ml of tuberntine were injected in the right pleura of 32 rabbits followed by the inoculation of 7log10 cfu/mL of one isolate of MDRPA on the next day. Isolate was resistant to PT, ceftazidime, imipenem and ciprofloxacin. Rabbits were then equally divided into four groups: A, controls; B, intravenous 80 mg/kg CL followed by a second dose of 30 mg/kg two hours after; C, intravenous 400 mg/kg of PT; D: both agents. Therapy was administered only the next day of bacterial challenge. Pleura was punctured each second day; fluid was quantitatively cultured. On the seventh day, rabbits were sacrificed and the segments of the lower lobe of the right lung were quantitatively cultured.

Results: Mean values of bacteria are given in the Table. Mean log10 of bacteria in lung after sacrifice of groups A, B, C and D was 4.63, 5.53, 4.23 and 2.77.

Time (days)log10 cfu/mL
ABCD 
15.126.156.184.17
36.686.004.646.59
53.984.805.002.22
74.104.063.951.49

Conclusions: Co-administration of CL and PT decreased considerably bacterial load in lung and pleural fluid. There co-administration is proposed for the management of nosocomial pneumonia and empyema by MDRPA.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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