ArticleJournal of clinical microbiology2010
In vitro evaluation of antibiotic synergy for polymyxin B-resistant carbapenemase-producing Klebsiella pneumoniae.
Article in Journal of clinical microbiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 127 citations in OpenAlex.
- Systematic review and meta-analysis of in vitro synergy of polymyxins and carbapenems.Antimicrobial agents and chemotherapy · 2013Pooled it
- Intrinsic Acidity of N-Acetylcysteine Mediates Enhanced Inhibition ofMicroorganisms · 2026Article
- In vitro Screening for Synergistic Polymyxin B-Based Combinations Against KPC- Producing Carbapenem-ResistantDrug design, development and therapy · 2026Article
- Doxycycline for Macrolide-ResistantInfection and drug resistance · 2026Review
- Investigation of antimicrobial synergism of actinomycin derivatives fromTurkish journal of biology = Turk biyoloji dergisi · 2026Article
- Favorable clinical outcome of recurrent deep chest wall infection caused by pan-resistant Klebsiella pneumoniae treated with cefotaxime plus polymyxin B: a case report.Revista da Sociedade Brasileira de Medicina Tropical · 2026Article
- The synergistic effect of the combination of polymyxin B and rifampicin in a murine neutropenic thigh infection model with E. coli and K. pneumoniae.The Journal of antimicrobial chemotherapy · 2025Article
- Development of polymyxin- and aminoglycoside-based outer membrane permeabilizers: a review.Frontiers in microbiology · 2025Review
- Synergistic antimicrobial combination of third-generation cephalosporins and polymyxin B against carbapenem-polymyxin-resistantAntimicrobial agents and chemotherapy · 2024Article
- Effectiveness of antimicrobial agent combinations against carbapenem-producingFrontiers in microbiology · 2024Article
- Resensitizing multidrug-resistant Gram-negative bacteria to carbapenems and colistin using disulfiram.Communications biology · 2023Article
- Combination of AS101 and Mefloquine Inhibits Carbapenem-ResistantInfection and drug resistance · 2023Article
- Integrated metabolomic and transcriptomic analyses of the synergistic effect of polymyxin-rifampicin combination against Pseudomonas aeruginosa.Journal of biomedical science · 2022Article
- Article
- Effectiveness of a double-carbapenem combinations against carbapenem-resistant Gram-negative bacteria.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2022Article
- Impact of a Novel Anticoccidial Analogue on SystemicAntibiotics (Basel, Switzerland) · 2022Article
- Article
- Evaluation of Benzguinols as Next-Generation Antibiotics for the Treatment of Multidrug-Resistant Bacterial Infections.Antibiotics (Basel, Switzerland) · 2021Article
- Rescuing the Last-Line Polymyxins: Achievements and Challenges.Pharmacological reviews · 2021Review
- Comparison of Two Transmission Electron Microscopy Methods to Visualize Drug-Induced Alterations of Gram-Negative Bacterial Morphology.Antibiotics (Basel, Switzerland) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since carbapenemase-producing Klebsiella pneumoniae strains were first reported in North Carolina, these highly resistant organisms have been isolated with increasing frequency, especially in the New York City area. Polymyxin B is one of the few antimicrobials that retain reliable activity against these organisms. However, polymyxin B MICs are elevated against K. pneumoniae isolates with increasing frequency, leaving clinicians with few therapeutic options. We investigated several antimicrobial agents for potential synergy with polymyxin B against 12 clinical strains of carbapenemase-producing K. pneumoniae. A broth microdilution assay using a 96-well plate was developed in which graded dilutions of polymyxin B and the study drug were incubated with resistant isolates in a checkerboard pattern. Polymyxin B was studied in combination with cefazolin, ceftriaxone, cefepime, imipenem, gentamicin, tigecycline, doxycycline, and rifampin. All K. pneumoniae strains tested positive for K. pneumoniae carbapenemase (KPC) genes by real-time PCR and had elevated polymyxin B MIC values ranging from 16 to 128 μg/ml. Synergy was observed with the combination of polymyxin B and rifampin as well as with polymyxin B and doxycycline, resulting in at least a 4-fold decrease in the polymyxin B MIC. For both combinations, this effect occurred at physiologically achievable concentrations. Less pronounced synergy was noted with tigecycline and polymyxin B. No synergy was observed at physiologic concentrations with the other antimicrobials studied. These results suggest that rifampin, doxycycline, and tigecycline may be useful additions to polymyxin B in the treatment of infections caused by highly resistant carbapenemase-producing K. pneumoniae. Further studies are warranted to determine if these in vitro findings translate into clinical efficacy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.