In Vitro Activity of Rifabutin and Rifampin against Antibiotic-Resistant Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae

Rifabutin has been recently described as a potential adjunctive therapy for antibiotic-resistant A. baumannii infections due to hypersensitivity in iron-depleted media, which may more closely mimic an in vivo environment. Here, we report that this hyperactivity is specific for A. baumannii , rather than being a general effect for other pathogens.

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Activité antibactérienne de l’huile essentielle de Pelargonium x asperum et son potentiel synergique avec la nisine

Phytothérapie ◽

10.3166/phyto-2019-0183 ◽

2019 ◽

Vol 17 (3) ◽

pp. 140-148 ◽

Cited By ~ 1

Author(s):

A. Ouelhadj ◽

L. Ait Salem ◽

D. Djenane

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Nous Avons ◽

Activité Antibactérienne

Ce travail vise l’étude de l’activité antibactérienne de l’huile essentielle (HE) de Pelargoniumx asperum et de la bactériocine, la nisine seul et en combinaison vis-à-vis de six bactéries dont quatre sont multirésistantes d’origine clinique. L’activité antibactérienne in vitro a été évaluée par la méthode de diffusion sur gélose. La concentration minimale inhibitrice (CMI) est aussi déterminée pour HE. Les résultats ont révélé une activité antibactérienne significative exercée par HE visà-vis de Staphylococcus aureus (ATCC 43300), Staphylococcus aureus et Escherichia coli avec des diamètres d’inhibition de 36,00 ; 22,50 et 40,00 mm, respectivement. Cependant, l’HE de Pelargonium asperum a montré une activité antibactérienne supérieure par rapport à la nisine. Les valeurs des CMI rapportées dans cette étude sont comprises entre 1,98–3,96 μl/ml. Les combinaisons réalisées entre HE et la nisine ont montré un effet additif vis-à-vis de Escherichia coli (ATCC 25922) avec (50 % HE Pelargonium asperum + 50 % nisine). Par contre, nous avons enregistré une synergie vis-à-vis de Klebsiella pneumoniae avec (75 % HE Pelargonium asperum + 25 % nisine) et contre Pseudomonas aeruginosa avec les trois combinaisons testées. Les résultats obtenus permettent de dire que l’HE de Pelargonium asperum possède une activité antibactérienne ainsi que sa combinaison avec la nisine pourrait représenter une bonne alternative pour la lutte contre l’antibiorésistance.

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Exogenous Alginate Protects Staphylococcus aureus from Killing by Pseudomonas aeruginosa

Journal of Bacteriology ◽

10.1128/jb.00559-19 ◽

2019 ◽

Vol 202 (8) ◽

Cited By ~ 2

Author(s):

Courtney E. Price ◽

Dustin G. Brown ◽

Dominique H. Limoli ◽

Vanessa V. Phelan ◽

George A. O’Toole

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Physical Space ◽

Late Time ◽

Protective Effects ◽

Content Type ◽

Alginate Production ◽

The Impact

ABSTRACT Cystic fibrosis (CF) patients chronically infected with both Pseudomonas aeruginosa and Staphylococcus aureus have worse health outcomes than patients who are monoinfected with either P. aeruginosa or S. aureus. We showed previously that mucoid strains of P. aeruginosa can coexist with S. aureus in vitro due to the transcriptional downregulation of several toxic exoproducts typically produced by P. aeruginosa, including siderophores, rhamnolipids, and HQNO (2-heptyl-4-hydroxyquinoline N-oxide). Here, we demonstrate that exogenous alginate protects S. aureus from P. aeruginosa in both planktonic and biofilm coculture models under a variety of nutritional conditions. S. aureus protection in the presence of exogenous alginate is due to the transcriptional downregulation of pvdA, a gene required for the production of the iron-scavenging siderophore pyoverdine as well as the downregulation of the PQS (Pseudomonas quinolone signal) (2-heptyl-3,4-dihydroxyquinoline) quorum sensing system. The impact of exogenous alginate is independent of endogenous alginate production. We further demonstrate that coculture of mucoid P. aeruginosa with nonmucoid P. aeruginosa strains can mitigate the killing of S. aureus by the nonmucoid strain of P. aeruginosa, indicating that the mechanism that we describe here may function in vivo in the context of mixed infections. Finally, we investigated a panel of mucoid clinical isolates that retain the ability to kill S. aureus at late time points and show that each strain has a unique expression profile, indicating that mucoid isolates can overcome the S. aureus-protective effects of mucoidy in a strain-specific manner. IMPORTANCE CF patients are chronically infected by polymicrobial communities. The two dominant bacterial pathogens that infect the lungs of CF patients are P. aeruginosa and S. aureus, with ∼30% of patients coinfected by both species. Such coinfected individuals have worse outcomes than monoinfected patients, and both species persist within the same physical space. A variety of host and environmental factors have been demonstrated to promote P. aeruginosa-S. aureus coexistence, despite evidence that P. aeruginosa kills S. aureus when these organisms are cocultured in vitro. Thus, a better understanding of P. aeruginosa-S. aureus interactions, particularly mechanisms by which these microorganisms are able to coexist in proximal physical space, will lead to better-informed treatments for chronic polymicrobial infections.

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Efeito antimicrobiano do extrato de Cranberry sobre micro-organismos causadores de infecção urinária

Cadernos UniFOA ◽

10.47385/cadunifoa.v11.n31.384 ◽

2016 ◽

Vol 11 (31) ◽

pp. 113-122

Author(s):

Carla Franco Porto Belmont Souza ◽

Luiz Eduardo Souza da Silva Irineu ◽

Renan Silva De Souza ◽

Renato da Silva Teixeira ◽

Ivina Sanches Pereira ◽

...

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Enterococcus Faecalis ◽

Proteus Mirabilis ◽

Enterococcus Faecium ◽

Vaccinium Macrocarpon ◽

Mueller Hinton

A resistência microbiana tem se mostrado um problema de proporções mundiais, causando estado de morbidade e mortalidade em diversos pacientes. Em vista disso, tem crescido a busca por métodos alternativos naturais de profilaxia. A investigação clínica sugere que o Extrato de Cranberry está entre as melhores propostas de prevenção natural. O Cranberry (Vaccinium macrocarpon) é um fruto que tem crescido comercialmente pelo sabor e propriedades benéficas à saúde. Dentre as formas comercializadas estão: o suco, o chá e as cápsulas contendo o extrato seco. A ação desta planta está relacionada ao tratamento de doenças do trato urinário, por possuir substâncias que inibem a adesão bacteriana ao epitélio do trato urinário, dificultando sua proliferação e reprodução. Dentre todas as infecções relacionadas à assistência a saúde, a Infecção do Trato Urinário é a mais frequentemente associada a procedimentos invasivos. Se não for tratada, pode resultar em complicações como pielonefrite aguda, bacteremia e pionefrose. Portanto, cranberry pode ser uma nova alternativa para o combate das infecções uroepiteliais, por ser um produto natural de preço acessível, e com formas de comercialização diversificada, ao contrário dos antimicrobianos convencionais, que por sua vez são caros e podem acabar causando resistência nos micro-organismos. Este trabalho teve como objetivo avaliar in vitro a atividade antimicrobiana do extrato de Cranberry, adquirido em farmácia de manipulação, sobre 8 micro-organismos isolados de infecções urinárias. As cepas utilizadas, adquiridas da coleção da FIOCRUZ, foram: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Serratia marscecens, Staphylococcus aureus, Enterococcus faecalis e Enterococcus faecium. No estudo, foram utilizados o caldo Mueller Hinton (MH), Extrato de Cranberry e as bactérias patogênicas. O ensaio foi realizado em triplicata, com o uso de um controle de crescimento dos micro-organismos e o experimento para avaliação do crescimento bacteriano na presença do extrato. A turbidez foi medida com o auxílio de um espectrofotômetro, no comprimento de onda de 600 nm, antes e após 24 horas de incubação à 37 ºC. O procedimento forneceu a Densidade Ótica, do qual possibilitou a identificação da inibição microbiana. Para análise estatística foi utilizado o Teste t de Student. O Extrato de Cranberry apresentou atividade antimicrobiana sobre as bactérias Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Serratia marscecens e Enterococcus faecalis (p < 0,05), confirmando seu efeito benéfico em infecções urinárias. No entanto, não teve efeito inibitório significativo sobre Pseudomonas aeruginosa, Proteus mirabilis e Enterococcus faecium (p > 0,05).

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Actividad antibacteriana in vitro de aceites esenciales de diferentes especies del género Citrus

Revista Colombiana de Ciencias Químico Farmacéuticas ◽

10.15446/rcciquifa.v46n2.67934 ◽

2017 ◽

Vol 46 (2) ◽

Cited By ~ 2

Author(s):

Miladys Esther Torrenegra Alarcón ◽

Nerlis Paola Pájaro ◽

Glicerio León Méndez

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Staphylococcus Epidermidis ◽

E Coli

Se evaluó la actividad antibacteriana in vitro de aceites esenciales de diferentes especiesdel género Citrus frente a cepas ATCC de Staphylococcus aureus, Staphylococcus epidermidis,Klebsiella pneumoniae, Pseudomonas aeruginosa y Escherichia coli, determinandola concentración mínima inhibitoria (CMI) y la concentración mínima bactericida(CMB). Las bacterias se replicaron en medios de agar y caldos específicos. Se determinóel momento de máxima densidad óptica (DO620) para emplearlo como tiempode incubación; luego se hicieron pruebas de evaluación de sensibilidad con la exposiciónde las cepas a concentraciones a 1000 g/mL del extracto en caldo. Para solubilizarse empleó dimetilsulfóxido (DMSO) al 1%. Posteriormente, se le determinó laconcentración mínima inhibitoria mediante metodologías de microdilución en caldoy la concentración mínima bactericida. Encontrándose una actividad de los aceitesesenciales del género Citrus, con valores de CMI ≥ 600 mg/mL frente a S. aureus,S. epidermidis, K. pneumoniae, P. aeruginosa y E. coli. En función a los resultados obtenidos,se concluye que las diferentes especies del género Citrus son consideradas comopromisorias para el control del componente bacteriano.

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In VitroandIn VivoActivities of OP0595, a New Diazabicyclooctane, against CTX-M-15-Positive Escherichia coli and KPC-Positive Klebsiella pneumoniae

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02704-15 ◽

2016 ◽

Vol 60 (5) ◽

pp. 3001-3006 ◽

Cited By ~ 11

Author(s):

Akihiro Morinaka ◽

Yuko Tsutsumi ◽

Keiko Yamada ◽

Yoshihiro Takayama ◽

Shiro Sakakibara ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Infection Model ◽

Gram Negative Bacteria ◽

Content Type ◽

Effective Combination ◽

Time Kill ◽

Lactamase Inhibitor

ABSTRACTGram-negative bacteria are evolving to produce β-lactamases of increasing diversity that challenge antimicrobial chemotherapy. OP0595 is a new diazabicyclooctane serine β-lactamase inhibitor which acts also as an antibiotic and as a β-lactamase-independent β-lactam “enhancer” againstEnterobacteriaceae. Here we determined the optimal concentration of OP0595 in combination with piperacillin, cefepime, and meropenem, in addition to the antibacterial activity of OP0595 alone and in combination with cefepime, inin vitrotime-kill studies and anin vivoinfection model against five strains of CTX-M-15-positiveEscherichia coliand five strains of KPC-positiveKlebsiella pneumoniae. An OP0595 concentration of 4 μg/ml was found to be sufficient for an effective combination with all three β-lactam agents. In bothin vitrotime-kill studies and anin vivomodel of infection, cefepime-OP0595 showed stronger efficacy than cefepime alone against all β-lactamase-positive strains tested, whereas OP0595 alone showed weaker or no efficacy. Taken together, these data indicate that combinational use of OP0595 and a β-lactam agent is important to exert the antimicrobial functions of OP0595.

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In Vitro Activity of Imipenem against Carbapenemase-Positive Enterobacteriaceae Isolates Collected by the SMART Global Surveillance Program from 2008 to 2014

Journal of Clinical Microbiology ◽

10.1128/jcm.02316-16 ◽

2017 ◽

Vol 55 (6) ◽

pp. 1638-1649 ◽

Cited By ~ 30

Author(s):

James A. Karlowsky ◽

Sibylle H. Lob ◽

Krystyna M. Kazmierczak ◽

Robert E. Badal ◽

Katherine Young ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Klebsiella Oxytoca ◽

Enterobacter Cloacae ◽

Surveillance Program ◽

In Vitro Activity ◽

Content Type ◽

Carbapenemase Gene ◽

Check Points

ABSTRACT The Study for Monitoring Antimicrobial Resistance Trends (SMART) global surveillance program collected 103,960 isolates of Enterobacteriaceae from 2008 to 2014. From this isolate collection, all ertapenem-nonsusceptible isolates (MIC, ≥1 μg/ml; n = 3,428) and 9,371 isolates of Escherichia coli , Klebsiella pneumoniae , Klebsiella oxytoca , and Proteus mirabilis with an ertapenem-susceptible extended-spectrum-β-lactamase (ESBL)-positive phenotype were assessed for the presence of common carbapenemase genes using a Check-MDR CT101 microarray (Check-Points, Wageningen, the Netherlands) and published multiplex PCR assays. Testing identified 1,493 isolates that harbored a carbapenemase gene (1,485 ertapenem-nonsusceptible isolates and 8 ertapenem-susceptible ESBL-positive isolates) and accounted for 1.4% (1,493/103,960) of all isolates of Enterobacteriaceae . The most frequently identified carbapenemase genes were the KPC ( n = 794), OXA-48-like ( n = 300), and NDM ( n = 290) genes. Carbapenemase genes were most frequently identified in Klebsiella pneumoniae ( n = 1,127), Escherichia coli ( n = 149), and Enterobacter cloacae ( n = 110). Among the carbapenemase-positive isolates, 66.7% (2/3), 37.0% (111/300), 20.0% (8/40), 3.3% (3/92), 2.3% (18/794), and 0% (0/290) of the isolates with genes for GES, OXA-48-like, IMP, VIM, KPC, and NDM, respectively, were susceptible to imipenem (MIC, ≤1 μg/ml). Isolates that tested as susceptible to imipenem were not uncommon among carbapenemase-positive isolates (9.4%, 141/1,493) and most frequently carried OXA-48-like enzymes (78.7%; 111/141); however, overall, these isolates remained rare (0.1%, 141/103,960). The practice of screening clinical isolates of Enterobacteriaceae that test as susceptible to carbapenems in vitro for the presence of carbapenemase genes remains controversial and requires further study.

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Methionine Limitation Impairs Pathogen Expansion and Biofilm Formation Capacity

Applied and Environmental Microbiology ◽

10.1128/aem.00177-19 ◽

2019 ◽

Vol 85 (9) ◽

Cited By ~ 4

Author(s):

A. Jochim ◽

T. Shi ◽

D. Belikova ◽

S. Schwarz ◽

A. Peschel ◽

...

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Human Serum ◽

Bacterial Infections ◽

Bacterial Species ◽

Biosynthesis Pathway ◽

Methionine Biosynthesis ◽

Content Type

ABSTRACTMultidrug-resistant bacterial pathogens are becoming increasingly prevalent, and novel strategies to treat bacterial infections caused by these organisms are desperately needed. Bacterial central metabolism is crucial for catabolic processes and provides precursors for anabolic pathways, such as the biosynthesis of essential biomolecules like amino acids or vitamins. However, most essential pathways are not regarded as good targets for antibiotic therapy since their products might be acquired from the environment. This issue raises doubts about the essentiality of such targets during infection. A putative target in bacterial anabolism is the methionine biosynthesis pathway. In contrast to humans, almost all bacteria carry methionine biosynthesis pathways which have often been suggested as putative targets for novel anti-infectives. While the growth of methionine auxotrophic strains can be stimulated by exogenous methionine, the extracellular concentrations required by most bacterial species are unknown. Furthermore, several phenotypic characteristics of methionine auxotrophs are only partly reversed by exogenous methionine. We investigated methionine auxotrophic mutants ofStaphylococcus aureus,Pseudomonas aeruginosa, andEscherichia coli(all differing in methionine biosynthesis enzymes) and found that each needed concentrations of exogenous methionine far exceeding that reported for human serum (∼30 µM). Accordingly, these methionine auxotrophs showed a reduced ability to proliferate in human serum. Additionally,S. aureusandP. aeruginosamethionine auxotrophs were significantly impaired in their ability to form and maintain biofilms. Altogether, our data show intrinsic defects of methionine auxotrophs. This result suggests that the pathway should be considered for further studies validating the therapeutic potential of inhibitors.IMPORTANCENew antibiotics that attack novel targets are needed to circumvent widespread resistance to conventional drugs. Bacterial anabolic pathways, such as the enzymes for biosynthesis of the essential amino acid methionine, have been proposed as potential targets. However, the eligibility of enzymes in these pathways as drug targets is unclear because metabolites might be acquired from the environment to overcome inhibition. We investigated the nutritional needs of methionine auxotrophs of the pathogensStaphylococcus aureus,Pseudomonas aeruginosa, andEscherichia coli. We found that each auxotrophic strain retained a growth disadvantage at methionine concentrations mimicking those availablein vivoand showed that biofilm biomass was strongly influenced by endogenous methionine biosynthesis. Our experiments suggest that inhibition of the methionine biosynthesis pathway has deleterious effects even in the presence of external methionine. Therefore, additional efforts to validate the effects of methionine biosynthesis inhibitorsin vivoare warranted.

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Silver Oxynitrate, an Unexplored Silver Compound with Antimicrobial and Antibiofilm Activity

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.05177-14 ◽

2015 ◽

Vol 59 (7) ◽

pp. 4031-4039 ◽

Cited By ~ 35

Author(s):

Joe A. Lemire ◽

Lindsay Kalan ◽

Alexandru Bradu ◽

Raymond J. Turner

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Antibiofilm Activity ◽

Metal Compounds ◽

Antibiotic Resistant ◽

Content Type ◽

New Antibiotics ◽

Silver Compound ◽

Therapeutic Compound

ABSTRACTHistorically it has been accepted, and recent research has established, that silver (Ag) is an efficacious antimicrobial agent. A dwindling pipeline of new antibiotics, combined with an increase in the number of antibiotic-resistant infections, is bringing Ag to the fore as a therapeutic compound to treat infectious diseases. Currently, many formulations of Ag are being deployed for commercial and medical purposes, with various degrees of effectiveness at killing microbial cells. Here, we evaluated the antimicrobial and antibiofilm capacity of our lead compound, silver oxynitrate [Ag(Ag3O4)2NO3or Ag7NO11], against other metal compounds with documented antimicrobial activity, including Ag2SO4, AgNO3, silver sulfadiazine (AgSD), AgO, Ag2O, and CuSO4. Our findings reveal that Ag7NO11eradicates biofilm and planktonic populations ofPseudomonas aeruginosa,Escherichia coli,Staphylococcus aureus, uropathogenicEscherichia coli(UPEC), fluoroquinolone-resistantPseudomonas aeruginosa(FQRP), and methicillin-resistantStaphylococcus aureus(MRSA) at lower concentrations than those of the other tested metal salts. Altogether, our results demonstrate that Ag7NO11has an enhanced efficacy for the treatment of biofilm-forming pathogens.

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AÇÃO ANTIMICROBIANA DAS FLORES DE ANACARDIUM OCCIDENTALE E DO ÁCIDO ELÁGICO PRESENTE NO EXTRATO

10.51161/rems/965 ◽

2021 ◽

Author(s):

Pâmela Gomes Santos ◽

Rosane Nassar Meireles Guerra ◽

Josivan Regis Farias ◽

Simone Batista Muniz ◽

Danielle Cristine Gomes Franco

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Streptococcus Mutans ◽

Enterococcus Faecalis ◽

Tenebrio Molitor ◽

Anacardium Occidentale

Introdução: As infecções bacterianas têm aumentado significativamente nas últimas décadas, sobretudo aquelas ocasionadas por microrganismos multirresistentes. Assim, o uso de produtos naturais com finalidades terapêuticas surge com alvo de bioprospecção na busca de novos compostos com ação antimicrobiana. Além disso, o uso de insetos, como o Tenebrio molitor como modelo experimental para avaliação in vivo tem sido muito frequente, pois exige menos material em relação aos testes com animais vertebrados. Objetivo: O presente trabalho investigou o efeito citotóxico e ação antimicrobiana do extrato hidroalcoólico das flores de Anacardium occidentale (EHAo) e do ácido elágico. Material e Métodos: Avaliamos a citoxicidade de ácido elágico e do EHAo nas concentrações (1; 5 e 50mg/kg) em Tenebrio molitor. A ação antimicrobiana para Enterococcus faecalis, Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Pseudomonas aeruginosa e Klebsiella pneumoniae e a toxicidade do ácido elágico, foi avaliada por microdiluição, segundo a norma M7-A6 do manual da Clinical and Laboratory Standards Institute – CLSI. Foi determinada a Concentração Bactericida Mínima (CBM) e concentração inibitória mínima (CIM), em culturas de 24 horas, incubadas à 37ºC. Resultados: No ensaio de citotoxidade aguda se verificou que nenhuma das concentrações usados foram tóxicas, pois não ocorreram óbitos e nem nenhuma anormalia morfológica nas larvas de Tenebrio molitor. Os testes de concentração inibitória mínima (CIM) de concentração bactericida mínima (CBM) mostraram que o EHAo apresentou ação bactericida para Enterococcus faecalis em todas as concentrações testadas. Para Staphylococcus aureus os resultados mostraram ação bactericida para as maiores concentrações e bacteriostática para a menor diluição. O ácido elágico teve ação bactericida apenas para Enterococcus faecalis. Para as bactérias Streptococcus mutans, Escherichia coli, Pseudomonas aeruginosa e Klebsiella pneumoniae as concentrações de EHAo e ácido elágico testadas não foram inibitórias. Conclusões: Os resultados mostraram baixa toxicidade tanto para o EHAo como para o ácido elágico e ainda, que o extrato apresentou melhor efeito antimicrobiano do que o ácido elágico, para Enterococcus faecalis e Staphylococcus aureus.

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In Vivo Antibacterial Activities of Sanfetrinem Cilexetil, a New Oral Tricyclic Antibiotic

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.42.7.1858 ◽

1998 ◽

Vol 42 (7) ◽

pp. 1858-1861 ◽

Cited By ~ 11

Author(s):

Shinobu Tamura ◽

Shuichi Miyazaki ◽

Kazuhiro Tateda ◽

Akira Ohno ◽

Yoshikazu Ishii ◽

...

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Streptococcus Pyogenes ◽

Respiratory Infections ◽

Antibacterial Activities ◽

Murine Models ◽

In Vitro Activity ◽

Number Of Bacteria

ABSTRACT The in vivo antibacterial activities of a new oral trinem, sanfetrinem cilexetil (a prodrug of sanfetrinem), were evaluated in comparison with those of cefdinir and amoxicillin. Sanfetrinem cilexetil showed potent efficacy against experimental murine septicemia caused by Staphylococcus aureus, Streptococcus pyogenes, and Escherichia coli and against murine respiratory infections caused by Streptococcus pneumoniae. Likewise, in murine models of respiratory infection by penicillin-susceptible and penicillin-resistant S. pneumoniae, sanfetrinem cilexetil was more effective than amoxicillin in reducing the number of bacteria in infected lungs. These results were reflected in its potent in vitro activity and high levels in plasma.

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