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Table 3 Combination therapy for multidrug-resistant organisms: in vitro and clinical studies

From: The role of carbapenems in initial therapy for serious Gram-negative infections

Author, year In vitro/clinical study Setting/organism Susceptibility Therapy Outcome
Zuravleff et al. (1983) [48] In vitro study 33 isolates of Pseudomonas aeruginosa All resistant to rifampin; 12 resistant to tobramycin alone; one resistant to ticarcillin alone; three resistant to tobramycin + ticarcillin Ticarcillin, tobramycin, plus rifampin In vitro efficacy against all 33 isolates
Yoon et al. (2004) [45] In vitro study 8 isolates of Acinetobacter baumannii All resistant to all commonly used antibiotics Polymyxin B plus imipenem; polymyxin B plus rifampin; polymyxin B, imipenem, plus rifampin Double combinations were bactericidal for seven isolates and the triple combination was bactericidal for all eight isolates within 24 hours in vitro
Ostenson et al. (1977) [47] Clinical report Serious infections due to Serratia marcescens All resistant to polymyxin B and rifampin Polymyxin B plus rifampin Clinical and bacteriologic cure in eight out of 12 patients (67%)
Korvick et al. (1992) [46] Clinical study 121 patients with P. aeruginosa bacteremia All organisms were susceptible to the β-lactam and aminoglycoside administered Randomized to three drugs (β-lactam, aminoglycoside, and rifampin; n = 58) or two drugs (β-lactam and aminoglycoside; n = 63) Bacteriologic cure was significantly greater with three drugs (57 patients [98%]) than with two drugs (54 patients [86%]; P = 0.018)