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M E Erwin

Publications and source records attributed to M E Erwin.

At least 73 records · Page 4Linked to original sources

Antimicrobial activity of ten macrolide, lincosamine and streptogramin drugs tested against Legionella species.

RP59500, a semisynthetic pristinamycin combination, and 14 other antimicrobial agents were tested against 108 Legionella strains. Of the ten macrolide, lincosamine and streptogramin agents tested, the new streptogramin RP59500 ranked seventh in order of activity against Legionella pneumophila on the basis of MIC90 results as follows: clarithromycin = 14-OH clarithromycin (MIC90 0.12 mg/l) > roxithromycin > erythromycin = tylosin = virginiamycin > RP59500 (MIC90 1 mg/l) = azithromycin > dirithromycin > clindamycin (MIC90 8 mg/l). Of all 14 drugs tested in this study, rifampicin was the most potent with an MIC90 of 0.008 mg/l. In this retrospective study of Legionella strains (1981-1990 isolates), we observed no trend toward resistance to the agents investigated.

Amino Sugars↗

Interpretive criteria and quality control guidelines for lomefloxacin and meropenem in susceptibility tests of Haemophilus influenzae using Haemophilus test medium.

Lomefloxacin and meropenem were tested in a multilaboratory study to establish susceptibility testing interpretive criteria and quality control (QC) guidelines for Haemophilus influenzae using Haemophilus test medium (HTM). Interpretive criteria were established by using triplicate testing of 102 representative H. influenzae strains. Only a susceptible category was proposed for lomefloxacin (greater than or equal to 22 mm and less than or equal to 2 micrograms/ml) and meropenem (greater than or equal to 13 mm and less than or equal to 4 micrograms/ml) due to the lack of resistant isolates. QC range for H. Influenzae ATCC 49247 were established using multiple HTM agar and broth base lots, three disk lots for each drug, and a number of test replicates consistent with the National Committee for Clinical Laboratory Standards M23-T guideline.

Anti-Infective Agents↗

CI-960 (PD127391 or AM-1091), sparfloxacin, WIN 57273, and isepamicin activity against clinical isolates of Mycobacterium avium-intracellularae complex, M. chelonae, and M. fortuitum.

A 7H9 broth microdilution method against CI-960, sparfloxacin, WIN57273, ciprofloxacin, norfloxacin, isepamicin, amikacin, kanamycin, ethambutol, isoniazid, and rifampin was used to test 35 Mycobacterium avium-intracellulare complex (MAI) and five M. chelonae-fortuitum strains. The majority of MAI isolates were inhibited by all tested compounds, with sparfloxacin (MIC90, 0.5 micrograms/ml) being the most active among the fluoroquinolones; isepamicin (MIC90, 4 micrograms/ml), the most potent aminoglycoside; and isoniazid, rifampin, and ethambutol also demonstrating some degree of activity. Mycobacterium chelonae strains were resistant to all drugs except ciprofloxacin (MIC50, 1 microgram/ml). Mycobacterium fortuitum isolates were generally susceptible, especially to the newer fluoroquinolones.

Anti-Bacterial Agents↗

New insights into the activity of third-generation cephalosporins against pneumonia-causing bacteria.

Over 300 isolates representing all pathogens causing greater than or equal to 4% of nosocomial or outpatient pneumonias were tested against currently used third-generation cephalosporins (cefotaxime, desacetylcefotaxime, ceftriaxone, ceftazidime, cefoperazone, and ceftizoxime) to determine differences in activity and effects of physiologic host and pharmacokinetic properties. Prevalent drug resistances were represented and tests were performed by reference methods of the National Committee for Clinical Laboratory Standards. Spectrums and potency of cefotaxime, desacetylcefotaxime, ceftriaxone, and ceftizoxime were most similar, but cefotaxime plus desacetylcefotaxime at in vivo ratios increased the cefotaxime spectrum (anaerobes and Pseudomonas) and potency. Ceftizoxime was least active because of current reduced activity against some Staphylococcus spp. and Pseudomonas aeruginosa. Ceftriaxone potency was adversely affected (greater than or equal to 4-fold decrease) by serum protein binding, thus reducing its susceptibility spectrum for pathogens with greater than or equal to 4 micrograms/ml minimum inhibitory concentrations (MICs) and a 10.6% reduced spectrum overall. Ceftazidime provided poorest coverage against the significant and clinically increasing Gram-positive cocci and did not significantly inhibit aspiration pneumonia causing anaerobic strains. Ceftazidime and cefoperazone were more active against pseudomonas, but they were most labile to newer extended-spectrum beta-lactamases. On empiric balance, the third-generation cephalosporins continue to provide the best therapeutic spectrum, particularly those favorably influenced by host factors (proteins and metabolism). These third-generation cephalosporin differences become more important since some agents (ceftazidime) have readily selected type-I enzyme mutants among intensive-care-unit respiratory tract pathogens at our institution. Cost containment will also influence drug choices for some third-generation cephalosporins, usually favoring the earliest introduced compounds such as cefotaxime.

Bacteria↗

Ofloxacin, a new broad-spectrum fluoroquinolone. Results from a Multicenter, National Comparative Activity Surveillance Study. The Ofloxacin Surveillance Group.

Ofloxacin, a newer broad-spectrum fluoroquinolone, was evaluated against 6967 clinical isolates in a multicenter surveillance trial using a standardized disk diffusion method. Thirty-five geographically diverse laboratories contributed zone diameter results for two (ofloxacin and ciprofloxacin) to five (ofloxacin, ciprofloxacin, ampicillin, cefaclor, and cefixime) antimicrobial agents, depending on the site of infection. Ofloxacin was determined to have the widest spectrum of activity and potential empiric use (90.6%, range 87.1%-92.2%) for respiratory tract, urinary tract, and cutaneous infections. The spectrum was superior to ciprofloxacin (average 85.3% versus three sites), ampicillin (35.5%, respiratory tract), cefaclor (60.5%, respiratory tract), cefixime (60.9%, respiratory tract), and norfloxacin (87.3%, urinary tract). Strains resistant to ofloxacin (35 isolates, 0.5%) were confirmed by reference laboratory tests and cross resistance was observed among several current and investigational fluoroquinolone agents. The species most often found to be fluoroquinolone resistant among the Enterobacteriaceae were Klebsiella pneumoniae, Serratia marcescens, and Providencia spp. Monitoring for increasing fluoroquinolone resistance should be considered as greater use of drugs in this class develops. By these cited statistics, ofloxacin appears to have a broad and balanced spectrum of potential use, particularly against Gram-positive pathogens.

Anti-Infective Agents↗

In vitro activity of CP-74667 compared with four other fluoroquinolones.

CP-74667 is a new, novel C-7 diazabicyclo-fluoroquinolone. Its spectrum of activity includes the Enterobacteriaceae, most nonenteric Gram-negative bacilli, and Gram-positive cocci. Particularly high activity was demonstrated against Xanthomonas maltophilia (MIC50, 1 microgram/ml), Staphylococcus spp. (MIC50s, 0.06-0.12 micrograms/ml) and enterococci (MIC50s, 0.5-4 micrograms/ml). Several staphylococci resistant to ciprofloxacin had potentially susceptible range MICs for CP-74667, for example, less than or equal to 2 micrograms/ml. Fluoroquinolones with this C-7 modification appear promising and worthy of continued pharmaceutical investigation.

Anti-Infective Agents↗

Cefdinir (FK482), an orally administered cephalosporin in vitro activity comparison against recent clinical isolates from five medical centers and determination of MIC quality control guidelines.

Cefdinir, a new oral cephalosporin, was compared to cefaclor, cefadroxil, cefixime, and cefuroxime against greater than 5000 recent aerobic clinical isolates. This multicenter study revealed broad-spectrum cefdinir activity against all Enterobacteriaceae (MIC50s, 0.06-2 micrograms/ml) except Enterobacter cloacae, Morganella morganii, Proteus vulgaris, and Serratia marcescens (MIC50s, greater than or equal to 4 micrograms/ml). Oxacillin-susceptible staphylococci (MIC90s, 0.5-2 micrograms/ml), beta-hemolytic Streptococcus group B (MIC90, 0.06 micrograms/ml), and Acinetobacter lwoffii were also susceptible to cefdinir. The activity of cefdinir was similar to that of cefixime and cefuroxime against Gram-negative organisms and superior to all tested oral cephems when tested against Gram-positive cocci. None of the cephalosporins were active against oxacillin-resistant Staphylococcus spp., enterococci, Pseudomonas spp., or Xanthomonas maltophilia. MIC quality control range guidelines were established for the strains recommended by the National Committee for Clinical Laboratory Standards documents.

Anti-Bacterial Agents↗

In vitro evaluation of Ro 09-1227, a novel catechol-substituted cephalosporin.

Ro 09-1227 is a novel 7-position catechol-substituted parenteral cephalosporin that also has a 3-position radical similar to previously described cephems. The Ro 09-1227 spectrum was slightly wider than that of ceftazidime against members of the family Enterobacteriaceae tested, principally because of greater activity against species producing Richmond-Sykes type I beta-lactamases. Ro 09-1227 was also more active than ceftazidime against some strains producing extended-spectrum plasmid-encoded beta-lactamases, such as TEM-3, -4, -5, -6, -7, and -9, SHV-2 and -3, and CAZ-2. Most strains of Pseudomonas aeruginosa, Xanthomonas maltophilia, and Acinetobacter spp. were also more susceptible to Ro 09-1227 than cefotaxime, ceftriaxone, cefoperazone, and ceftazidime. Haemophilus influenzae (MIC for 90% of strains tested [MIC90], 0.5 micrograms/ml), Neisseria gonorrhoeae (MIC90, 0.015 micrograms/ml), and Moraxella (Branhamella) catarrhalis (MIC90, 0.5 micrograms/ml) were also Ro 09-1227 susceptible. Ro 09-1227 activity against important gram-positive cocci was most comparable to that of ceftazidime. Bacteroides fragilis (MIC90, greater than 32 micrograms/ml) and the enterococci (MIC90, greater than 32 micrograms/ml) were resistant to Ro 09-1227. These in vitro results indicate that this catechol-substituted cephalosporin may be useful as an empiric agent, especially for some isolates resistant to currently available broad-spectrum cephalosporins.

Bacteria↗

Antimicrobial activities of two investigational fluoroquinolones (CI-960 and E4695) against over 100 Legionella sp. isolates.

The antimicrobial activities of two investigational fluoroquinolones (CI-960 and E4695) were compared with those of five similar compounds and four comparison drugs against 103 strains of Legionella pneumophila and five other Legionella species type strains. When concentrations inhibiting 90% of strains tested (MIC90s) for L. pneumophila were determined, CI-960 and temafloxacin emerged as the most active (0.015 microgram/ml) and were followed in potency by E4695 (0.03 microgram/ml). This activity was two- to fourfold greater than that of the reference drug, ciprofloxacin, and approached that of rifampin (MIC90, 0.008 microgram/ml). All fluoroquinolones studied were more active than erythromycin (MIC90, 0.5 microgram/ml). These two investigational fluoroquinolones appear well suited for further in vivo study of legionellosis therapy.

Anti-Infective Agents↗

MIC quality control guidelines for Haemophilus susceptibility tests using cefdinir (FK482), cefepime, cefetamet, cefpirome, ceftibuten, fleroxacin, temafloxacin, clarithromycin, RP59500, and trospectomycin.

A multilaboratory study was performed to establish broth microdilution MIC quality control (QC) guidelines for 10 investigational drugs which previously demonstrated significant activity against Haemophilus influenzae. MIC QC ranges for H. influenzae ATCC 49247 with Haemophilus test medium were determined by using multiple contemporary lots of Haemophilus test medium and the National Committee for Clinical Laboratory Standards' recommended numbers of replicate tests. On the basis of these results, QC ranges (generally modal MIC +/- one log2 dilution) are proposed for cefdinir, cefepime, cefetamet, cefpirome, ceftibuten, fleroxacin, temafloxacin, clarithromycin, RP59500, and trospectomycin. The proposed QC guidelines for clarithromycin and temafloxacin were recently accepted by the National Committee for Clinical Laboratory Standards.

Anti-Bacterial Agents↗

Disk diffusion quality control guidelines for Haemophilus susceptibility tests using cefdinir, CI-960, fleroxacin, temafloxacin, and trospectomycin.

A multilaboratory study to determine disk diffusion quality control ranges for Haemophilus influenzae ATCC 49247 and five investigational drugs was performed. Multiple lots of Haemophilus Test Medium and antibiotic disks were used for replicate testing in conformance with the recommendations of the National Committee for Clinical Laboratory Standards. Quality control disk zone diameter ranges were proposed for cefdinir, CI-960, fleroxacin, temafloxacin, and trospectomycin.

Anti-Bacterial Agents↗

Interpretive criteria for disk diffusion tests using 5-microgram cefdinir disks with rapidly growing clinical isolates.

Preliminary interpretive zone diameter criteria were calculated for the 5-micrograms cefdinir disk diffusion test by using two potential MIC breakpoints (less than or equal to 0.5 and less than or equal to 1 micrograms/ml). The absolute agreement between tests ranged from 85.9 to 92.4%, and the false-susceptibility errors were principally contributed by the Enterobacter spp. (2.2% error). One proposed criterion was greater than or equal to 20-mm zone diameter (less than or equal to 1 micrograms/ml) for susceptibility and less than or equal to 16-mm zone diameter (greater than 2 micrograms/ml) for resistance to cefdinir. Clinical laboratory users of the disk diffusion method should be cautioned about the possibility of very major interpretive errors among enterobacter isolates.

Cefdinir↗

Interpretive criteria for susceptibility testing of CI-960 (PD127391, AM-1091), fleroxacin, lomefloxacin, and temafloxacin against Neisseria gonorrhoeae, including drug stability in GC agar medium.

CI-960, fleroxacin, lomefloxacin, and temafloxacin were tested against over 100 strains of Neisseria gonorrhoeae. Each organism was tested in triplicate by using agar dilution and disk diffusion methods recommended by the National Committee for Clinical Laboratory Standards. CI-960 was the most potent compound, with a MIC against 90% of the strains tested of 0.008 microgram/ml, and the least active was fleroxacin (MIC against 90% of strains, 0.12 microgram/ml). Only the susceptible interpretive category was recommended for the CI-960 tests as follows: 5-micrograms disk, greater than or equal to 39 mm (MIC correlate, less than or equal to 0.12 microgram/ml). Three interpretive categories were proposed for the other fluoroquinolones as follows: fleroxacin, 5-micrograms disk susceptible at greater than or equal to 33 mm (MIC correlate, less than or equal to 0.25 microgram/ml), intermediate at 28 to 32 mm (MIC correlate, 0.5 microgram/ml), and resistant at less than or equal to 27 mm (MIC correlate, greater than 0.5 microgram/ml); lomefloxacin, 10-micrograms disk susceptible at greater than or equal to 35 mm (MIC correlate, less than or equal to 0.12 microgram/ml), intermediate at 28 to 34 mm (MIC correlates, 0.25 to 0.5 microgram/ml), and resistant at less than or equal to 27 mm (MIC correlate, greater than 0.5 microgram/ml); and temafloxacin, 5-micrograms disk susceptible at greater than or equal to 36 mm (MIC correlate, less than or equal to 0.06 microgram/ml), intermediate at 28 to 35 mm (MIC correlates 0.12 to 0.25 microgram/ml), and resistant at less than or equal to 27 mm (greater than 0.25 microgram/ml). Interpretive agreement between disk diffusion results and the MICs was 100% for each agent, with the exception of lomefloxacin, which had a 0.9% minor error. All drugs were stable in GC agar medium for at least 21 days when stored at 2 to 5 degrees C.

Agar↗

Preliminary disk diffusion susceptibility testing criteria for cefdaloxime (RU29246, HR-916 metabolite), a new orally administered cephalosporin.

Cefdaloxime (formerly RU29246; Hoechst-Roussel Pharmaceuticals Inc., Somerville, N.J.) a new active component of the HR-916 ester, was tested by dilution and two disk (10- and 30-micrograms) diffusion susceptibility tests against 391 clinical isolates. Interpretive criteria were proposed for three potential MIC breakpoints of less than or equal to 1, less than or equal to 2, and less than or equal to 4 micrograms/ml. Analyses by regression line and error rate bounding methods minimized false-susceptible (very major) errors and produced a greater than or equal to 90% absolute interpretive agreement between susceptibility test methods. The less than or equal to 2-micrograms/ml breakpoint seemed optimal when 10-micrograms disks and the available human pharmacokinetics were used. The following inhibition zone diameter criteria were proposed: susceptible, greater than or equal to 19 mm; resistant, less than or equal to 15 mm. These recommendations for clinical trials should remain tentative until additional information about cefdaloxime formulations, pharmacokinetics, and patient outcomes can be correlated with in vitro susceptibility test results.

Administration, Oral↗

MIC and disk diffusion quality control guidelines for Neisseria gonorrhoeae susceptibility tests of cefdinir, cefetamet, CI-960, fleroxacin, lomefloxacin, and temafloxacin.

Cefdinir (FK482), cefetamet (Ro 15-8074), CI-960, fleroxacin, lomefloxacin, and temafloxacin have potent activities against Neisseria gonorrhoeae. They were tested in a multilaboratory study to establish quality control guidelines. Quality control ranges for N. gonorrhoeae ATCC 49226 were determined by using multiple GC agar lots, three disk lots, and a number of test replicates consistent with the M23-T guidelines of the National Committee for Clinical Laboratory Standards. The MIC ranges included 2 to 4 log2 dilution steps. The recommended inhibition zone diameter ranges were generally 7 to 8 mm and included greater than or equal to 91.3% of all recorded study results.

Anti-Infective Agents↗

Antimicrobial activity of RU29246 (HR916 metabolite) compared with four other oral beta-lactams tested against more than 5000 clinical isolates.

The activity of RU29246, the active metabolite of the oral cephalosporin ester HR916, was compared in a multicenter study with that of the four oral beta-lactam antibiotics cephalexin, cefaclor, cefixime and amoxicillin/clavulanate (amoxicillin/CA). RU29246 was generally 2- to 8-fold more active than the other oral cephalosporins and comparable to amoxicillin/CA against staphylococci, and was the most active cephalosporin against group B streptococci. All four cephalosporins were ineffective against enterococci. RU29246 was the only cephalosporin consistently active against Acinetobacter, but all beta-lactam antibiotics had poor activity against Pseudomonas spp. and Xanthomonas maltophilia. RU29246 was comparable to cefixime and more active than the other cephalosporins against members of the family Enterobacteriaceae. However, all of the antibiotics had poor activity against Enterobacter cloacae and Serratia marcescens. Quality control reference ranges for the quality control organisms Staphylococcus aureus ATCC 29213 and Escherichia coli ATCC 25922 are proposed for the broth dilution method based on data derived from this multicenter study.

Amoxicillin↗

Antimicrobial activity of isepamicin (SCH21420, 1-N-HAPA gentamicin B) combinations with cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, imipenem, mezlocillin and piperacillin tested against gentamicin-resistant and susceptible gram-negative bacilli and enterococci.

Isepamicin, formerly SCH21420 or 1-N-HAPA gentamicin B, is an aminoglycoside that was tested alone or in combination with one of seven broad spectrum drugs against 80 clinical isolates. Half of the strains were gentamicin-resistant but only one isolate (1.3%) was resistant to isepamicin. The broadest spectrum comparison drugs tested alone (ciprofloxacin at 3.8% resistance and imipenem at 5.0% resistance) were associated with the lowest synergy rates when combined with isepamicin. The rank order of synergy (complete or partial) was; cefotaxime = ceftazidime = ceftriaxone = mezlocillin = piperacillin (75% to 80%) greater than imipenem (66%) greater than ciprofloxacin (38%). Isepamicin/ampicillin combinations produced synergistic killing of those enterococci not having high-grade resistance to gentamicin or kanamycin. Enterococcus faecium strains were also refractory to isepamicin/ampicillin synergy. Isepamicin appears to be widely useable against gentamicin-resistant gram-negative bacilli either alone or combined with most commonly used broad spectrum beta-lactams.

Cefotaxime↗