Table 3

Combination therapy for multidrug-resistant organisms: in vitro and clinical studies

Author, year
In vitro/clinical study
Setting/organism
Susceptibility
Therapy
Outcome

Zuravleff et al. (1983) [48]
In vitro study
33 isolates of Pseudomonas aeruginosa
All resistant to rifampin; 12 resistant to tobramycin alone; one resistant to ticarcillin alone; three resistant to tobramycin + ticarcillin
Ticarcillin, tobramycin, plus rifampin
In vitro efficacy against all 33 isolates
Yoon et al. (2004) [45]
In vitro study
8 isolates of Acinetobacter baumannii
All resistant to all commonly used antibiotics
Polymyxin B plus imipenem; polymyxin B plus rifampin; polymyxin B, imipenem, plus rifampin
Double combinations were bactericidal for seven isolates and the triple combination was bactericidal for all eight isolates within 24 hours in vitro
Ostenson et al. (1977) [47]
Clinical report
Serious infections due to Serratia marcescens
All resistant to polymyxin B and rifampin
Polymyxin B plus rifampin
Clinical and bacteriologic cure in eight out of 12 patients (67%)
Korvick et al. (1992) [46]
Clinical study
121 patients with P. aeruginosa bacteremia
All organisms were susceptible to the β-lactam and aminoglycoside administered
Randomized to three drugs (β-lactam, aminoglycoside, and rifampin; n = 58) or two drugs (β-lactam and aminoglycoside; n = 63)
Bacteriologic cure was significantly greater with three drugs (57 patients [98%]) than with two drugs (54 patients [86%]; P = 0.018)

Rahal Critical Care 2008 12(Suppl 4):S5   doi:10.1186/cc6821