In Vitro Bactericidal Activity of Trimethoprim-Sulfamethoxazole/Colistin Combination Against Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates

Microb Drug Resist. 2019 Mar;25(2):152-156. doi: 10.1089/mdr.2018.0085. Epub 2018 Aug 15.

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a formidable health challenge in recent years owing to the shortage of effective antibiotics. Colistin is the last and sometimes the only therapeutic option for CRKP infections. Unfortunately, resistance to colistin monotherapy is likely to develop. CRKP in China reportedly exhibit low rates of resistance to trimethoprim-sulfamethoxazole. The aim of this study was to evaluate the in vitro efficacy of trimethoprim-sulfamethoxazole in combination with colistin against four CRKP clinical isolates. The trimethoprim-sulfamethoxazole/colistin combination rapidly killed all four of the tested isolates after 2 h up to 24 h. Trimethoprim-sulfamethoxazole is one of the few remaining antimicrobials with some activity against CRKP. In particular, combined with colistin, trimethoprim-sulfamethoxazole might be promising for the treatment of CRKP infections.

Keywords: bactericidal activity; carbapenem-resistant; colistin; trimethoprim–sulfamethoxazole.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology*
  • China / epidemiology
  • Colistin / pharmacology*
  • Drug Resistance, Bacterial / drug effects*
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Microbial Sensitivity Tests
  • Molecular Epidemiology
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Colistin