Fosfomycin and mecillinam have been used extensively for the treatment of UTIs, mainly in Scandinavia and Europe, for decades while resistance rates remain low (12).
Pivmecillinam is the prodrug which releases the active agent mecillinam when absorbed.
The aim of this study was to gather local data on the in-vitro susceptibilities of ESBL-producing Enterobacteriaceae from our institution, against two potentially useful oral antibiotics: fosfomycin and mecillinam, and to compare the results with other routinely tested oral agents.
Fosfomycin and mecillinam susceptibilities were retrospectively performed on non duplicate patient isolates.
Susceptibility testing for fosfomycin and mecillinam was performed by disk diffusion using CLSI guidelines.
Fosfomycin and mecillinam were the most effective oral antimicrobials in-vitro, compared to other oral agents tested.
In this study we have found both fosfomycin and mecillinam to have a high in-vitro activity against a range of ESBL-producing Enterobacteriaceae, especially against E.
Although mecillinam has performed well in in-vitro studies against ESBL-producing Enterobacteriaceae, authors have warned against its use as mono therapy due to the apparent effect of high bacterial inoculum, and hence high concentrations of [beta]-lactamase production, which increases the MIC level of mecillinam (32,33).
Antimicrobial drug resistance phenotypes in randomly isolated Escherichia coli from wild and domestic birds, Bangladesh Domestic birds, n = 52 Drug Tetracycline 24 Trimethoprim/sulfamethoxazole 17 Ampicillin 15 Cephradine 0 Cefuroxime 2 Cefadroxil 0 Nalidixic acid 11 Ciprofloxacin 3 Streptomycin 3 Gentamicin 0 Fosfomycin 0 Chloramphenicol 4 Nitrofurantoin 1 Tigecycline 0 Mecillinam
0 Wild birds, n = 14 Drug Tetracycline 1 Trimethoprim/sulfamethoxazole 2 Ampicillin 4 Cephradine 1 Cefuroxime 1 Cefadroxil 1 Nalidixic acid 1 Ciprofloxacin 1 Streptomycin 1 Gentamicin 1 Fosfomycin 1 Chloramphenicol 0 Nitrofurantoin 0 Tigecycline 0 Mecillinam
0 Table 2.
A Canadian National Surveillance Study of urinary tract isolates from outpatients: comparison of the activities of trimethoprim-sulfamethoxazole, ampicillin, mecillinam
, nitrofurantoin, and ciprofloxacin.
By using the agar diffusion method with Muller-Hinton agar, susceptibility was tested for the following 12 antimicrobial agents: ampicillin, chloramphenicol, streptomycin, sulfonamide, tetracycline, ciprofloxacin, trimethoprim, gentamicin, nalidixic acid, cefotaxime, mecillinam
, and imipenem (10).
coli with extended-spectrum [beta]-1actamases), chloramphenicol, ciprofloxacin, fosfomycin-trometamol, gentamicin, imipenem, mecillinam
, nalidixie acid, nitrofurantoin, streptomycin, sulfamethoxazole, tetracycline, trimethoprim, and tigecycline.