European Journal of Biomedical and Pharmaceutical Sciences

COMPARISON OF SENSITIVITY OF CEFUROXIME-CLAVULANIC ACID COMBINATION V/S CEFUROXIME ALONE IN BIOFILM AND/OR BETA-LACTAMASE-PRODUCING BACTERIA

Dr. Anuradha De, *Dr. Ruchi Tayal and Dr. Sujata Baveja

ABSTRACT

Introduction: Bacterial resistance against cephalosporins is most often mediated by -lactamases in both Gram-positive and Gram-negative bacteria. A novel approach to countering this is the delivery of a -lactam antibiotic in combination with a -lactamase inhibitor. Objectives: We intended to study the synergistic effect of Cefuroxime-Clavulanic Acid combination in biofilm and/or -lactamase producing Staphylococcus aureus and common Gram-negative bacilli isolated from clinical specimens and compare its efficacy with Cefuroxime alone. Methods: It was a retrospective study for a period of 3 months. Bacteria isolated from cases of urinary tract infections (UTIs), skin and soft tissue infections (SSTIs) and post-operative infections were identified by standard techniques. Out of these, 100 biofilm-producing and/or -lactamase producing bacteria were selected for this study. Detection of in-vitro biofilm formation was done by Congo Red Agar (CRA) method. Beta-lactamase production was tested by Clover leaf method. The antibiotics tested were cefuroxime (30μg) and cefuroxime-clavulanic acid combination in the ratio of 2:1. Results: With Cefuroxime-Clavulanic acid combination, overall susceptibility was 24% while for Cefuroxime alone, susceptibility was only 2%. Maximum combination susceptibility was seen in only biofilm producers (42.85%) which was statistically significant. Isolates from SSTIs showed 43.75% sensitivity to Cefuroxime-Clavulanic acid combination which was again statistically significant. Methicillin sensitive Staphylococcus aureus showed most significant response to treatment with this combination. All Gram negative bacteria showed less than 25% sensitivity to the Cefuroxime-Clavulanic acid combination. Conclusion: This combination can be recommended in SSTIs caused by Staphylococcus aureus and in infections where biofilm formation acts as a triggering factor for increased drug resistance. This combination cannot be recommended in Gram-negative bacterial isolates – -lactamase and/or biofilm producers.

Keywords: Cefuroxime-Clavulanic acid, Biofilm, beta-lactamase, drug resistance.