A solution to combat aminoglycoside and quinolone resistant gram negative organisms

This study was carried out to know the prevalence of aminoglycoside and quinolone resistance among the collected isolates and to analyze the antibiotic susceptiblity patterns of various drugs against these isolates to find which drug offers the best solution against multidrug resistant Gram negative pathogens. Total 1824 clinical samples were collected from patients suspected of bacterial infection between March 2013 to May 2014. These samples were subjected for bacterial identification. The prevalence of aminoglycoside and fluoroquinolone among these isolates and antibiotic susceptibility testing were carried out according to the recommendations of Clinical Laboratory Standards Institute (CLSI) guidelines. Among the samples analyzed, 82.2 % (1499/1824) samples showed the growth of organisms of which 22 % (400/1824) were Gram positive and 60.2 % (1099/1824) were Gram negative and included in this study. Further analysis of Gram negative organisms revealed that 46.7% (513/1099) were aminoglycoside and 53.3% (586/1099) were quinolone resistant. Among Gram negative organisms that identified were E. coli (n=302), P. aeruginosa (n=230), Acinetobacter species (n=217) K. pneumoniae (n=150), Proteus species (n=109) and Citrobacter species (n=91). Of the drugs tested, cefepime plus amkacin (Potentox) showed the highest activity against quinolone and aminoglycoside resistant Gram negative organisms with average susceptibility of >86% against all pathogens. Resistance to cefepime was 55%-74%, to tobramycin 20.8%-70.2%, to gentamycin 40%-65.6%, to levofloxacin 32.9%-62.4%, to moxifloxacin 40.1%-47.7%, to ofloxacin 29.9%-48.6%, to imipenem plus cilastatin 30%-60%, to ciprofloxacin 52.3%-75.7%, to ceftazidime 50.3%-60%, to azithromycin 40.5%-86%, and to amikacin 40.4%-79.7% among all isolated Gram negative bacterial pathogens. In conclusion, the results of this study strongly suggest the superiority of Potentox over other drugs and can be of effective alternative to treat infections caused by multi drug resistant Gram negative bacteria.