In vitro susceptibilities of 180 clinical isolates of Haemophilus influenzae to ampicillin, amoxycillin/clavulanate, cefaclor, cefuroxime, cefotaxime, clarithromycin, and azithromycin

Delmée, Michel;Glupczynski, Gerald;Carpentier, M.;Gordts, B.;Vannoyen, R.;et.al.
(1996) Acta Clinica Belgica (Multilingual Edition) — Vol. 51, n° 4, p. 237-243 (1996)

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  • Delmée, MichelUCLouvain
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  • Glupczynski, GeraldUCLouvain
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  • Carpentier, M.
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  • Gordts, B.
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  • Simon, AnneUCLouvain
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  • Vannoyen, R.
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Abstract
One hundred eighty consecutive, unduplicate isolates of Haemophilus influenzae from clinical specimens collected from November 1994 through February 1995 in nine general hospitals throughout Belgium were examined for beta-lactamase production using a nitrocefin-based test, and for their in vitro susceptibilities to ampicillin, amoxycillin/clavulanate, cefaclor, cefuroxime, cefotaxime, clarithromycin and azithromycin by means of the NCCLS agar dilution test. The isolates were all from respiratory tract specimens. The prevalence of capsular type b was 1.1%, and the overall rate of beta-lactamase production 16.7%. Rates of beta-lactamase production were higher in isolates from children (22.0%) than in those from adults (15.3%), and in isolates from upper respiratory tract specimens (22.0%) than in those from the lower respiratory tract (15.1%). Beta-lactamase-negative ampicillin resistance amounted to 1.1%. Cefotaxime had the highest activity on a weight basis [MIC (minimal inhibitory concentration) for 50% of the isolates tested (MIC(50)) less than or equal to 0.06 mu g/ml], followed by ampicillin (MIC(50) of 0.25 mu g/ml), amoxycillin/clavulanate and cefuroxime (MIC(50) of 0.5 mu g/ml), azithromycin (MIC(50) of 2 mu g/ml), cefaclor (MIC(50) of 4 mu g/ml), and clarithromycin (MIC(50) of 8 mu g/ml). Cefotaxime was also the most active drug in terms of susceptibility rates of the isolates (100.0%), followed by amoxycillin/clavulanate and azithromycin (98.9%), cefuroxime (97.2%), cefaclor (89.4%), clarithromycin (82.8%), and ampicillin (82.2%). In conclusion, amoxycillin/clavulanate and cefuroxime retain an excellent activity against H. influenzae, while cefaclor lost some of its activity. The rate of susceptibility to azithromycin was markedly higher than that to clarithromycin; however, its ability to accumulate intracellularly while concentrations in serum and interstitial fluid remain low, should be considered, as it may represent a major drawback to its use in H. influenzae infections.
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Delmée, M., Glupczynski, G., Carpentier, M., Gordts, B., Magerman, K., Simon, A., Surmont, I., VanDeVyvere, M., Vanlanduyt, H., VanNimmen, L., & Vannoyen, R. (1996). In vitro susceptibilities of 180 clinical isolates of Haemophilus influenzae to ampicillin, amoxycillin/clavulanate, cefaclor, cefuroxime, cefotaxime, clarithromycin, and azithromycin. Acta Clinica Belgica (Multilingual Edition), 51(4), 237-243. https://hdl.handle.net/2078.5/143758 (Original work published 1996)