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Open AccessArticle

In Vitro Activities of Colistin and Sitafloxacin Combinations against Multidrug-, Carbapenem-, and Colistin-Resistant Acinetobacter baumannii Using the Broth Microdilution Checkerboard and Time-Kill Methods

1
Faculty of Pharmacy, Siam University, Bangkok 10160, Thailand
2
Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
3
Faculty of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
*
Author to whom correspondence should be addressed.
Antibiotics 2020, 9(8), 516; https://doi.org/10.3390/antibiotics9080516
Received: 4 June 2020 / Revised: 7 August 2020 / Accepted: 11 August 2020 / Published: 14 August 2020
(This article belongs to the Special Issue Antibacterial Resistance and Novel Therapeutic Strategies)
Drug-resistant Acinetobacter baumannii (A. baumannii) infections are a critical global problem, with limited treatment choices. This study aims to determine the in vitro activities of colistin–sitafloxacin combinations against multidrug-, carbapenem- and colistin-resistant A. baumannii (MDR-AB, CRAB, CoR-AB, respectively) clinical isolates from tertiary care hospitals. We used the broth microdilution checkerboard and time-kill methods in this study. Synergy was found using both methods. The colistin–sitafloxacin combination showed synergy in MDR-AB, CRAB, and CoR-AB isolates (3.4%, 3.1%, and 20.9%, respectively). No antagonism was found in any type of drug-resistant isolate. The majority of CoR-AB isolates became susceptible to colistin (95.4%). The time-kill method also showed that this combination could suppress regrowth back to the initial inocula of all representative isolates. Our results demonstrated that the colistin–sitafloxacin combination might be an interesting option for the treatment of drug-resistant A. baumannii. However, further in vivo and clinical studies are required. View Full-Text
Keywords: polymyxin; fluoroquinolone; multidrug-resistant Gram-negative bacteria; carbapenem-resistant Gram-negative bacteria; colistin-resistant Gram-negative bacteria; combination; synergy; synergistic effect polymyxin; fluoroquinolone; multidrug-resistant Gram-negative bacteria; carbapenem-resistant Gram-negative bacteria; colistin-resistant Gram-negative bacteria; combination; synergy; synergistic effect
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Rodjun, V.; Houngsaitong, J.; Montakantikul, P.; Paiboonvong, T.; Khuntayaporn, P.; Yanyongchaikit, P.; Sriyant, P. In Vitro Activities of Colistin and Sitafloxacin Combinations against Multidrug-, Carbapenem-, and Colistin-Resistant Acinetobacter baumannii Using the Broth Microdilution Checkerboard and Time-Kill Methods. Antibiotics 2020, 9, 516.

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