Synergistic Effects of Amikacin With Imipenem and Ciprofloxacin Against Multidrug-Resistance Uropathogenic Escherichia coli
Abstract
Introduction: There are limited therapeutic options available for treating aminoglycoside- and carbapenem-resistant Gram-negative bacteria. Therefore, there is an urgent need for novel effective antimicrobial agents. Numerous studies have reported the enhanced efficacy of antibiotic combinations against multidrug-resistant (MDR) strains compared to monotherapy. This study aimed to investigate the potential synergistic effects of amikacin in combination with imipenem and ciprofloxacin against clinical isolates of MDR Escherichia coli to identify the most promising antibiotic combinations for treating infections caused by these isolates.
Methods: In this experimental study, 20 MDR E. coli isolates were examined. The minimum inhibitory concentration (MIC) and checkerboard method were determined for amikacin, imipenem, and ciprofloxacin.
Results: MIC determination revealed ciprofloxacin MICs of 4-512 μg/mL, imipenem 0.125-32 μg/mL, and amikacin 1-128 μg/mL. Resistance rates were 55% (11/20) for amikacin, 100% (20/20) for ciprofloxacin, and 55% (11/20) for imipenem. Synergistic effects were observed between amikacin and imipenem in 50% of isolates (10/20) and between amikacin and ciprofloxacin in 40% (8/20), with no antagonistic interactions detected.
Conclusions: The combination of amikacin with imipenem or ciprofloxacin resulted in synergistic and additive effects in some cases. These findings suggest that antibiotic combination therapy could serve as an effective strategy in…
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