ArticleAntimicrobial agents and chemotherapy2016
Sequential Treatment of Biofilms with Aztreonam and Tobramycin Is a Novel Strategy for Combating Pseudomonas aeruginosa Chronic Respiratory Infections.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 38 citations in OpenAlex.
- Trial
- Phenotypic convergence and collateral susceptibility development in Pseudomonas aeruginosa under antibiotic exposure in ICU patients.npj antimicrobials and resistance · 2026Article
- The Multifaceted Mechanistic Actions of Antimicrobial Nanoformulations: Overcoming Resistance and Enhancing Efficacy.Pharmaceutics · 2026Review
- Broadly Defined Antibiotic Adjuvants forThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Review
- Review
- Activation of theInfection and immunity · 2025Article
- Mutational signature analysis predicts bacterial hypermutation and multidrug resistance.Nature communications · 2025Article
- Collateral susceptibility-guided alternation of ceftolozane/tazobactam with imipenem prevents resistance development in XDRBiofilm · 2024Article
- Review
- In Vitro Antibiofilm Activity of Fosfomycin Alone and in Combination with Other Antibiotics against Multidrug-Resistant and Extensively Drug-ResistantPharmaceuticals (Basel, Switzerland) · 2024Article
- Mechanisms of antibiotic resistance inBiofilm · 2023Article
- Endemic High-Risk Clone ST277 Is Related to the Spread of SPM-1-ProducingMicroorganisms · 2023Article
- Pseudomonas aeruginosa persister cell formation upon antibiotic exposure in planktonic and biofilm state.Scientific reports · 2022Article
- Therapeutic Approach of ChronicAntibiotics (Basel, Switzerland) · 2021Article
- Cystic Fibrosis: Recent Insights into Inhaled Antibiotic Treatment and Future Perspectives.Antibiotics (Basel, Switzerland) · 2021Review
- Tolerance and Persistence ofFrontiers in microbiology · 2020Review
- Genomic Analysis Identifies Novel Pseudomonas aeruginosa Resistance Genes under Selection during Inhaled Aztreonam TherapyAntimicrobial agents and chemotherapy · 2019Article
- Commentary: Tolerance and Resistance ofFrontiers in microbiology · 2019Article
- Emerging therapies against infections withF1000Research · 2019Review
- Evolutionary ecology meets the antibiotic crisis: Can we control pathogen adaptation through sequential therapy?Evolution, medicine, and public health · 2019Review
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Traditional therapeutic strategies to control chronic colonization in cystic fibrosis (CF) patients are based on the use of a single nebulized antibiotic. In this study, we evaluated the therapeutic efficacy and dynamics of antibiotic resistance in Pseudomonas aeruginosa biofilms under sequential therapy with inhaled aztreonam (ATM) and tobramycin (TOB). Laboratory strains PAO1, PAOMS (hypermutable), PAOMA (mucoid), and PAOMSA (mucoid and hypermutable) and two hypermutable CF strains, 146-HSE (Liverpool epidemic strain [LES-1]) and 1089-HSE (ST1089), were used. Biofilms were developed using the flow cell system. Mature biofilms were challenged with peak and 1/10-peak concentrations of ATM (700 mg/liter and 70 mg/liter), TOB (1,000 mg/liter and 100 mg/liter), and their alternations (ATM/TOB/ATM and TOB/ATM/TOB) for 2 (t = 2), 4 (t = 4), and 6 days (t = 6). The numbers of viable cells (CFU) and resistant mutants were determined. Biofilm structural dynamics were monitored by confocal laser scanning microscopy and processed with COMSTAT and IMARIS software programs. TOB monotherapy produced an intense decrease in CFU that was not always correlated with a reduction in biomass and/or a bactericidal effect on biofilms, particularly for the CF strains. The ATM monotherapy bactericidal effect was lower, but effects on biofilm biomass and/or structure, including intense filamentation, were documented. The alternation of TOB and ATM led to an enhancement of the antibiofilm activity against laboratory and CF strains compared to that with the individual regimens, potentiating the bactericidal effect and/or the reduction in biomass, particularly at peak concentrations. Resistant mutants were not documented in any of the regimens at the peak concentrations and only anecdotally at the 1/10-peak concentrations. These results support the clinical evaluation of sequential regimens with inhaled antibiotics in CF, as opposed to the current maintenance treatments with just one antibiotic in monotherapy.
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