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In vitro Microbiological Evaluation of Cefuroxime and its Combinations with Gentamicin and Sisomicin

Cefuroxime is a new semi-synthetic cephalosporin with increased resistance to fi-lactamases from Gram negative bacteria. Preliminary investigations have shown it to have a high antimicrobial activity and to be among the best tolerated cephalosporins ((Freiesleben et al. 1977). The present evaluation was designed to test the susceptibility of both Gram positive and Gram negative bacteria to cefuroxime in comparison to cephalothin. Also, because of the increase of multi-resistant bacteria in hospitals, the effectiveness was examined of combinations of cefuroxime with gentamicin and sisomicin. These results were compared to those ofcephalothin -aminoglycoside combinations. Minimum Inhibitory Concentrations (MIC values) were determined in Mueller-Hinton broth using the tube dilution procedure. To examine the combination effect, a sub-inhibitory concentration of 0.2 Mug of gentamicin or sisomicin was added to each of the geometric dilutions of cefuroxime or cephalothin. The definitions used for addition and synergism were those recommended by Bulger & Kirby (1963): addition is defined as a reduction of MIC by 1-3 dilutions, and synergy as a reduction of 4 dilutions or more.